Search results for "hemorrhoid"
showing 10 items of 33 documents
Outpatient management of proctologic disease. Which techniques for local anesthesia? The experience of a single center
2019
Introduction. Since 1899 outpatient management of surgical patients had been increasing, becoming the best option when possible. In 1988 was described the first experience of outpatient management of proctologic disease. Advances in local anesthesia techniques have improved the outpatient approach to surgical disease, particularly in patients with proctological diseases. Methods. From 2010 to 2016, 1160 patients who needed surgery for proctologic disease have been recruited: 239 hemorrhoidectomies using the variant of Milligan Morgan technique described by Phillips, 45 trans-anal hemorrhoidal DE-arterialization (THD), 315 sphincterotomies, 12 anal polypectomies, 230 loop seton positions, 65…
Transanal hemorrhoidal dearterialization versus Milligan-Morgan hemorrhoidectomy in grade III/IV hemorrhoids.
2019
La terapia delle emorroidi di III e IV si basa sul trattamento chirurgico. All’emorroidectomia secondo Milligan Morgan (MM), da molti chirurghi considerata il gold standard, si affiancano attualmente metodi chirurgici considerati meno invasivi come la Procedura per Prolasso ed Emorroidi (PPH) e la dearterializzazione emorroidaria transanale (THD). Gli Autori hanno voluto confrontare in un trial prospettico e randomizzato la emorroidectomia secondo MM e la THD nel trattamento di emorroidi di III e IV grado valutandone i risultati a breve e medio termine. Materiali e metodi: Tra gennaio 2010 e marzo 2013 sono stati reclutati 87 pazienti con emorroidi di III e IV grado secondo la classificazio…
Colour doppler-guided haemorrhoidal artery ligation: A possible evolution of transanal haemorrhoidal dearterialisation
2021
Introduction. Haemorrhoids are a very common disease, with a great economic burden. Many treatments have been developed for trying to solve the problem, being the standard not yet found. In 1995, Doppler-guided haemorrhoidal artery ligation was introduced, aiming to reduce postoperative pain and complications. In this work, an evolution of the aforementioned surgical technique was described. Materials and Methods.183 patients treated with standard Doppler-Guided Haemorrhoidal Artery Ligation were statistically compared with 225 patients dealt with Colour Doppler-Guided Haemorrhoidal Artery Ligation. The procedures were performed under local anaesthesia with patients in lithotomy position. A…
[Effectiveness of contemporary injection of botulinum toxin and topical application of glyceryl trinitrate against postoperative pain after Milligan-…
2007
PURPOSE: After haemorrhoidectomy the maximum resting pressure (MRP) of the anal canal is significantly increased. This increase play an important role in the making of postoperative pain. Recently, both the topical application of glyceryl trinitrate (GT) and the intrasphincter injection of botulinum toxin (Tox), resulted effective, in reducing temporary the MRP although with different mechanism of action. In this study the effectiveness and safe of contemporary injection of Tox and topical application of 300 mg/die of GT after Milligan-Morgan haemorrhoidectomy, were evaluated. MATERIALS AND METHODS: Ten patients, undergoing Milligan-Morgan haemorrhoidectomy for 3rd and 4th degree haemorrhoi…
Improvement of wound healing after hemorrhoidectomy: a double-blind, randomized study of botulinum toxin injection.
2005
PURPOSE: Hemorrhoidectomy is usually associated with significant pain during the postoperative period. The spasm of the internal sphincter seems to play in important role in the origin of pain. This study was designed to evaluate the effectiveness of intrasphincter injection of botulinum toxin after hemaorrhoidectomy in reducing the maximum testing pressure of the anal canal, accelerating wound healing, and decreasing postoperative pain when resting and during defecation. METHODS: Thirty patients with hemorrhoids of third and fourth degree were included in the study and randomized in two groups. Anorectal manometry was performed preoperatively and 5 and 30 days afterward ill all patients un…
Long-term manometric study of anal sphincter function after hemorrhoidectomy
2006
BACKGROUND AND AIM: Data on maximum resting pressure (MRP) and maximum squeeze pressure (MSP) changes after hemorrhoidectomy are not univocal and follow-up of patients undergoing surgery is mostly short-lived. The aim of this study was to prospectively examine during 1-year follow-up the long-term manometric results of MRP, MSP, and ultra slow wave activity (USWA) within a set of patients undergoing Milligan-Morgan hemorrhoidectomy as compared to healthy controls. MATERIALS AND METHODS: Twenty patients with hemorrhoids of third and fourth degree were enrolled and anorectal manometry was performed preoperatively, on the 5th day, and after 1, 6, and 12 months after surgery. RESULTS: On the 5t…
Botulinum toxin vs. topical glyceryl trinitrate ointment for pain control in patients undergoing hemorrhoidectomy: a randomized trial.
2007
PURPOSE: The maximum resting pressure in the anal canal is greatly raised after hemorrhoidectomy. This increase is likely to be the cause of postoperative pain, which is still the most troublesome early problem after hemorrhoidectomy. This study was designed to compare, after hemorrhoidectomy, the effects of intrasphincter injection of botulinum toxin vs. application of glyceryl trinitrate ointment in improving wound heating and reducing postoperative pain at rest or during defecation. METHODS: Thirty patients with hemorrhoids of third and fourth degree were included in the study and randomized in two groups. Anorectal manometry was performed preoperatively and 5 and 40 days after hemorrhoi…
Bacteremia after proctoscopy and hemorrhoidal injection sclerotherapy
1981
The incidence of bacteremia following proctoscopy and hemorrhoidal injection sclerotherapy was studied in 50 outpatients undergoing both procedures. Bacteremia was found in 2 per cent of the subjects after proctoscopy and in 8 per cent after sclerotherapy. None of the subjects developed symptoms of septicemia following the procedure. It is concluded that antibiotic prophylaxis should be used before sclerotherapy in patients with valvular heart disease or compromised host defense.
Randomized clinical trial of botulinum toxin injection for pain relief in patients with thrombosed external haemorrhoids
2008
Abstract Background Thrombosed external haemorrhoids are one of the most frequent anorectal emergencies. They are associated with swelling and intense pain. Internal sphincter hypertonicity plays a role in the aetiology of the pain. This study evaluated the efficacy and safety of an intrasphincteric injection of botulinum toxin for pain relief in patients with thrombosed external haemorrhoids. Methods Thirty patients with thrombosed external haemorrhoids who refused surgical operation were randomized into two groups. Patients received an intrasphincteric injection of either 0·6 ml saline or 0·6 ml of a solution containing 30 units botulinum toxin. Anorectal manometry was performed before tr…
Evaluation and management of hemorrhoids: Italian society of colorectal surgery (SICCR) consensus statement
2015
Hemorrhoids are one of the most common medical and surgical diseases and the main reason for a visit to a coloproctologist. This consensus statement was drawn up by the Italian society of colorectal surgery in order to provide practice parameters for an accurate assessment of the disease and consequent appropriate treatment. The authors made a careful search in the main databases (MEDLINE, PubMed, Embase and Cochrane), and all results were classified on the basis of the grade of recommendation (A-C) of the American College of Chest Physicians.