[Efficacy comparison of tissue selecting therapy stapler and procedure for prolapse and hemorrhoids in the treatment of severe hemorrhoids].
3
Citation
0
Reference
10
Related Paper
Citation Trend
Abstract:
To compare the efficacy and complication of tissue selecting therapy stapler (TST) and procedure for prolapse and hemorrhoids (PPH) in the treatment of severe hemorrhoids.Clinical data of 542 cases of severe hemorrhoids undergoing TST (258 cases) or PPH (284 cases) in The First Affiliated Hospital of Fujian Medical University from November 2010 to January 2012 were analyzed retrospectively. Operative parameters, efficacy and complication 3 months after operation were assessed and compared.No significant difference in cure rate between TST and PPH (96.5% vs. 95.4%) was found, while the operation time and hospital stay after operation in TST group were significantly shorter urgency [(20.6±4.7) vs. (26.4±6.3) min, (2.9±0.5) vs. (3.5±0.7) d, both P<0.05]. Incidences of postoperative pain, bleeding, anal urgency and urinary retention in TST group were significantly lower than those in PPH group (all P<0.01). No anal stenosis was observed in TST group, and 5 cases developed anal stenosis in PPH group (P<0.05). Hemorrhoid recurrence did not differ significantly between the two groups.The efficacy of TST and PPH is comparable for severe hemorrhoids patients, while TST is associated with faster postoperative recovery and less complications.Keywords:
Anal stenosis
Urinary retention
Cite
Purpose: We describe a modification of the Ferguson hemorrhoidectomy for circumferential prolapsed hemorrhoids. This details the operative procedure and compares the results of other radical methods in patients with circumferential hemorrhoidal disease. Methods: A total of 738 patients (mean age, 43 (range, 19-83) years) were treated with our modified Ferguson method under sedative analgesia between 1989 and 2004: 576 patients had Grade III and 162 patients had Grade IV hemorrhoids, and 131 patients also had a partial lateral internal sphincterotomy to correct anal hypertonia. Results: Postoperative bleeding occurred in 16 patients, 3 of whom required surgical hemostasis. Fecal impaction occurred in 11 patients and wound complications in 6 patients. Thirty-two patients needed bladder catheterization because of acute urinary retention. The median follow-up was 13.2 months in our outpatient department. One patient developed mild gas incontinence, five developed anal stenosis, and three had an anal fissure. Only three patients had recurrent skin tags, which did not affect their quality of life. Conclusions: Our modified Ferguson method represents a good choice for radical treatment of circumferential prolapsed hemorrhoids because it is easy to perform, has few complications, and provides satisfying results.
Urinary retention
Anal stenosis
Colorectal Surgery
Anal fissure
Cite
Citations (9)
Objective To assess the results of PPH in the treatment of heamorroidpexy.Methods We retrospectively reviewed clinical data for 216 patients(male 92 and female 68) who had undergone PPH.Average age was 41.0±24.8 years.Of 216 patients,grade Ⅱ in 26 patients,grade Ⅲand Ⅳ in 68,mixed hemorrhoids in 122.Results Average duration of surgery was 30 minutes.The width of the excised tissue was 2.5cm.Postoperative bleeding occurred in 4 patients,anal pain in 34 patients and urinary retention in 123 patients.There were no patients with fecal incontinence and anastomotic stricture.The mean follow-up was 6 months.There were 13 patients missed follow-up,203 patients remained follow-up,including 196 patients with hemorrhoids block were fully retracted,7 patients were incompletely retraction.Conclusions PPH is a safe,short and effective procedure in the management of hemorrhoids,and patients have few postoperative complications.Anastomotic height and depth of the purse-string suture is an important factor affecting the outcomes.
Urinary retention
Fecal Incontinence
Cite
Citations (0)
Objective To investigate the causes and prevention and therapeutic strategies of postoperative complications of procedure for prolapse and hemorrhoids(PPH) in the treatment of severe hemorrhoids.Methods From January 2002 to October 2008,90 cases with severe hemorrhoids received PPH were analyzed retrospectively.Results The postoperative complications of PPH were as follows:anastomotic bleeding in 6 cases,urinary retention in 43 cases,anal pain in 17 cases,hemorrhoidal mucosal dys-retraction in 2 cases,fine control defecation disturbance in 1 cases,and 1 cases of anal fistula.No anastomotic infection,anal stenosis,fecal incontinence,hemorrhoidal recurrence and rectovaginal fistula were found after operation.Conclusion PPH has good effectiveness,rapid recovery and less pain etc advantages,but still it has some complications.Strict controlled operation indication and enhancing perioperative management would reduce incidence of complication.
Rectovaginal Fistula
Anal stenosis
Fecal Incontinence
Urinary retention
Cite
Citations (0)
Twenty-five patients with second- or third-degree hemorrhoids were treated on an outpatient basis using a modified form of pile suture of Farag. There were no postoperative complications such as acute urinary retention, hemorrhage, infection, or anal stenosis. After follow-up for 12 to 18 months, the method has relieved bleeding in all patients and anal prolapse in 96 per cent of them. The modified pile suture is useful in a tropical setting where excisional hemorrhoidectomy is a costly operation.
Anal stenosis
Urinary retention
Colorectal Surgery
Outpatient clinic
Cite
Citations (37)
The treatment of hemorrhoids has changed throughout the latter years. In selected cases hemorrhoidectomy with circular stapler, in personal opinion, is the best surgical technique. The goal of the present study is to evaluate the therapeutic results of hemorrhoidectomy by means of the above technique in 150 consecutive cases.From March 1997 to November 1999, 150 patients were surgically treated, 84 women and 66 men with a median age of 57 years. 130 patients had III degree, thus with a reducible prolapse, 10 IV degree and 10 patients with II degree hemorrhoids resistant to ambulatory banding and/or sclerotherapy. Every patient was operated with the circular stapler in Day Surgery regimen, and the patients were discharged after 24 hours.Eight immediate hemorrhages were seen, four of which were surgically treated; 10 patients had urinary retention which required an urinary catheter. Healing was complete in the 15-20th day. The follow-up after one month was performed on 140 patients, at 3 months and at one year, on 100 patients. No suture stenosis and no recurrences of the hemorrhoid prolapse were observed. Follow-up after 6, 12 and 24 months on 100 patients was also considered in order to evaluate the results after surgery and late complications or sequelae. Fifteen patients were reevaluated after one and two months with anorectal manometry which did not demonstrate important alterations of the continence.The advantages of this technique is to carry out a radical surgical procedure in a single event, by means of a rapid and mini-invasive technique, with an earlier physical recovery, with the absence of medication in the postoperative period, and an early social and working reestablishment.
Anal stenosis
Urinary retention
Rectal prolapse
Regimen
Cite
Citations (4)
Objective To explore the short-term effects of external excision and internal injection sclerotherapy-assisted improved procedure for prolapsed hemorrhoids(PPH)on circumferential mixed hemorrhoids.Methods A total of 142patients with circumferential mixed hemorrhoids were divided into two groups.The treatment group(n=70)received external excision and internal injection sclerotherapy-assisted improved PPH.The control group(n=72)received internal ligation,internal injection sclerotherapy and external excision.The pain and bleeding were observed at 24hours after operation.The anal margin edema,anal pendant expansion,anal stenosis,urinary retention and other complications were observed at 3days after operation.In addition,the length of postoperative hospital stay and time to resuming to normal living or working were recorded. Results Pain score and bleeding at 24hours after operation,anal margin edema and anal pendant expansion at 3days after operation,and length of postoperative hospital stay and time to resuming to normal living or working in treatment group were significantly different from those in control group(P0.01),the incidence of posto perative urinary retention there was no statitically significant difference(P0.05).The cure rate was 100%in both groups.No anal incontinence,anal stenosis,rectovaginal fistula and other complications were found in all patients.However,the longterm efficacy needed to be observed.Conclusion External excision and internal injection sclerotherapy-assisted improved PPH can reduce pain and postoperative complications and promote recovery in patients with circumferential mixed hemorrhoids.
Anal stenosis
Urinary retention
Cite
Citations (0)
Objective To discuss the application of PPH and factors of complication and countermeasure.Methods 40 cases of such Ⅲ～Ⅳ hemorrhoids patient in recent years who underwent this method were analyzed in clinical materials and follow-up materials retrospectively.Results The average operative time was 35 min,average hospitalized time was 2～4 days.The hemorrhoid had recovery with totalrectal mucosa.There were 5 cases with lower abdominal pain and 3 cases with slight incontinence and 1 case with perianal inflammation.There were no relapse and complication as stenosis or fistula after 3～6 months follow-up.2 cases had temporary blood stool.Conclusion The PPH might be a new technique to treat Ⅲ～Ⅳ hemorrhoid with easy,simple,safe,effective,short time,soon recovery and less pain characteristics.The key point to operate of this method was the level of 4～5 cm to anocutaneous line with total rectal mucosa and loop suture is important as well.
Anal stenosis
Cite
Citations (0)
Objective:To investigate the reasons and countermeasures of complications after procedure for prolapse and hemorrhoids(PPH).Methods:From June 2004 to June 2008,a total of 300 patients with grade III-IV hemorrhoids or mixed hemorrhoids underwent PPH in our department.The clinical data were studied and analyzed retrospectively.Results:The rate of complications was 31.3%(94/300),and the reasons included anastomotic bleeding in 3 cases,urinary retention in 36 cases,anastomotic stenosis in 7 cases,papilloma or hypertrophy of anal papillae in 52 cases,submucosal abscess of rectum in 1 case,sense of fall-swell in anus and residual stool in 86 cases and acute anal pain in 26 cases.Conclusion:The main reasons of complications after PPH are abnormal medical conducts during perioperative period.The postoperative complications can be decreased by means of improvement of professional skills and strict implementation of operative guides.
Anal stenosis
Urinary retention
Anus
Cite
Citations (0)
Objective To investigate the clinical efficacy of the automatic ligation and external piles resection treatment for mixed hemorrhoids.Methods A retrospective analysis was made on treatment of 90 cases with mixed hemorrhoids using automatic ligation and external piles resection.The efficacy and the complications were assessed.Results Of the 90 patients,II degree hemorrhoids in 51 cases,Ⅲ degree hemorrhoids in 39 cases.The mean operation time was 13(range 10-18)minutes.The mean hospital stay time was 3(range 2-5)days.Of the 90 patients,urinary retention 5 patients(5.6%),anal bulge 16 patients(17.8%),fecal urgency 2 patients(2.2%),postoperative bleeding 2 patients(2.2%),no other complications found,such as anorectal stenosis and fecal incontinence.Recurrence rate was 3.3% within a year follow-up.Conclusion Automatic ligation and external piles resection treatment for mixed hemorrhoids is a simple and safe procedure with low recurrence rate,minimal invasion,and definite efficacy,fewer complications,shorter hospital stay,etc.
Anal stenosis
Urinary retention
Fecal Incontinence
Clinical efficacy
Cite
Citations (0)