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J Med Case Rep 2019 Jan 15;13(1). Epub 2019 Jan 15.

uBiome, San Francisco, CA, USA.

Background: Hospitalization and antibiotic treatment can put patients at high risk for Clostridium difficile infection, where a disturbance of the gut microbiome allows for Clostridium difficile proliferation and associated symptoms, including mild, moderate, or severe diarrhea. Clostridium difficile infection is challenging to treat, often recurrent, and leads to almost 30,000 annual deaths in the USA alone. Here we present a case where SmartGut™, an at-home, self-administered sequencing-based clinical intestinal screening test, was used to identify the presence of Clostridium difficile in a patient with worsening diarrhea. Read More

Scand J Surg 2019 Jan 11:1457496918822619. Epub 2019 Jan 11.

1 Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, NSW, Australia.

Background:: Management of radiation proctitis presents a treatment challenge. Limited data exist on the management of symptomatic hemorrhoids in radiated patients. This study aims to present a practical approach to the management of radiation proctitis, particularly in patients with synchronous hemorrhoids. Read More

Surg Innov 2019 Jan 9:1553350618822644. Epub 2019 Jan 9.

1 Hospital Plató, Barcelona, Spain.

Purpose: To compare outcomes of hemorrhoid artery ligation with recto-anal repair (HAL-RAR) and excisional hemorrhoidectomy (EH). The primary objective was to compare postoperative pain, and the secondary objectives were the following: symptom resolution rates, postoperative morbidity, recurrence, and changes in quality of life.

Method: Prospective randomized controlled trial, including 40 patients with grades III-IV hemorrhoids who were allocated 1:1 to HAL-RAR and EH. Read More

Clin Transl Gastroenterol 2018 Nov 23;9(11):210. Epub 2018 Nov 23.

Drug Development Services, Pharmacy and Pharmaceutical Technology and Physical Chemistry Department, University of Barcelona, Barcelona, Spain.

Objective: The aim of this study is to evaluate the efficacy and safety of a topical formulation containing lidocaine plus diclofenac (CLIFE1) compared to lidocaine (CLIFE2), to decrease pain in benign anorectal surgery (BARS) to date not evaluated. More than 50% of patients undergoing BARS, especially hemorrhoidectomy, suffer from moderate and severe postoperative pain. This remains an unresolved problem that could be addressed with the new CLIFE1 topical treatment. Read More

Tech Coloproctol 2018 09 4;22(9):689-696. Epub 2018 Oct 4.

Proctological and Perineal Surgical Unit, Cisanello University Hospital, Via Paradisa 2, Pisa, Italy.

Background: Hemorrhoidal prolapse is a common benign disease. The introduction of circular-stapled hemorrhoidopexy as an alternative to the conventional hemorrhoidectomy led to a new spectrum of postoperative outcomes and complications. The aim of the present study was to evaluate long-term results after stapled hemorrhoidopexy. Read More

Medicine (Baltimore) 2018 Aug;97(32):e11820

Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University.

Background: Excisional hemorrhoidectomy (EH) is the major surgical option for high-grade symptomatic hemorrhoids, but it has some shortcomings, especially postoperative pain. This study was performed to assess the effect of lateral internal sphincterotomy (LIS) in patients undergoing excisional hemorrhoidectomy.

Methods: A systematic literature search (Medline, Embase, Cochrane Library, Science Citation Index, Science Direct, Springer Link, Ovid Journals, and EBSCO) was performed to identify all eligible articles. Read More

Medicine (Baltimore) 2018 Jul;97(29):e11502

Hunan Provincial Key Laboratory for Diagnostic and Therapeutic Research in Chinese Medicine, Hunan University of Chinese Medical, Changsha, Hunan Province, P.R. China.

Background And Objective: The aim of this study was to compare the outcomes of transanal hemorrhoidal dearterialization (THD) and stapled hemorrhoidectomy (SH) in the treatment of hemorrhoids by a meta-analysis.

Methods: Randomized control trials (RCTs) comparing SH with THD were searched for in databases, including MEDLINE, PubMed, Web of science, Embase, and the Cochrane Library database. Data were independently extracted from each study, and a meta-analysis was performed using RevMan5. Read More

J Surg Res 2018 Sep 9;229:283-287. Epub 2018 May 9.

Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; Geisel School of Medicine, Lebanon, New Hampshire. Electronic address:

Background: Surgery for anorectal diseases is thought to cause significant pain postoperatively. There is little known regarding standardized opioid-prescribing trends and patient use following surgery for anorectal diseases. We aimed to evaluate and analyze opioid-prescribing trends and patient use for outpatient anorectal operations. Read More

BMJ Case Rep 2018 May 18;2018. Epub 2018 May 18.

Department of Surgery, Hokkaido P.W.F.A.C Engaru-Kosei General Hospital, Engaru-cho Mombetsu-gun, Japan.

An 84-year-old man presented in 2009 with a sensation of discomfort in his anus, combined with difficulty in urination. He had previously undergone a haemorrhoidectomy in 1964. After examination, he was diagnosed with a rectal mucosal cyst and followed up for observation. Read More

Dis Colon Rectum 2018 Jul;61(7):824-829

Department of Surgery, University of Vermont Medical Center, Burlington, Vermont.

Background: Postoperative pain is a frequent cause for delayed discharge following outpatient procedures, including anorectal surgery. Both central and peripheral pain receptor sensitization are thought to contribute to postoperative pain. Blocking these receptors and preempting sensitization prevents hyperalgesia leading to lower pain medication requirements. Read More

Int J Colorectal Dis 2018 Jul 2;33(7):895-899. Epub 2018 May 2.

Department of General Surgery, SMS Medical College, Jaipur, Rajasthan, India.

Introduction: Post-hemorrhoidectomy pain is significantly associated with a hypertonicity of the internal anal sphincter. We evaluated the effects of topical diltiazem, a calcium channel blocker, in reducing pain after hemorrhoidectomy. Purpose of our study was to determine difference in extent of pain control by application of topical calcium channel blocker (diltiazem 2%) versus placebo ointment. Read More

Minerva Chir 2018 Oct 12;73(5):469-474. Epub 2018 Apr 12.

Maggiore Policlinic Hospital, IRCCS Ca' Granda Foundation, UOSD Day/Week Surgery, Milan, Italy.

Background: Conservative surgery of hemorrhoidal disease is less painful than traditional hemorrhoidectomy, and mucopexy has less risk of serious postoperative complications than stapled hemorrhoidopexy. The aim of this study was to evaluate the safety and effectiveness of a standardized, modified hemorrhoidopexy, named Mucopexy-Recto Anal Lifting (MuRAL) with the HemorPex System (HPS) in patients with symptomatic III and IV degree hemorrhoids.

Methods: Patients were enrolled from May 2013 to Dec 2015 and operated on with the MuRAL technique, based on arterial ligation and mucopexy at 6 locations, using a standardized clockwise/anti-clockwise rotation sequence of the HPS anoscope. Read More

Med Sci Monit 2018 Apr 12;24:2173-2179. Epub 2018 Apr 12.

Department of Pathology, Hitit University School of Medicine, Çorum, Turkey.

BACKGROUND The aim of this study was to investigate the early and late results of use of LigaSure, Harmonic Scalpel, and conventional hemorrhoidectomy in hemorrhoidectomy, to determine the least painful method, and to investigate the relationship between pain perception and personal differences in hemorrhoid bundles. MATERIAL AND METHODS Ninety patients undergoing hemorrhoidectomy between 2014 and 2017 were retrospectively evaluated. We investigated the duration of hospitalization and the presence of bleeding, incontinence, perianal wetness, urinary retention, stenosis, and recurrence during follow-up after surgery. Read More

Dis Colon Rectum 2018 Apr;61(4):491-498

Colorectal and Pelvic Floor Diseases Center, Department of General Surgery, S. Maria dei Battuti Hospital, Conegliano Veneto, Italy.

Background: Despite the advantages of stapled hemorrhoidopexy reported in the literature in terms of postoperative pain, hospital stay, and duration of convalescence, it was described to have a higher recurrence rate compared with conventional hemorrhoidectomy.

Objective: The aim of this study was to evaluate clinical outcomes and patient satisfaction after stapled hemorrhoidopexy at 10-year follow-up.

Design: This was a retrospective cohort analysis conducted on prospectively collected data. Read More

World J Surg 2018 09;42(9):3015-3020

Department of Surgery, Faculty of Medicine, Kuwait University, P.O. Box 24923, 13110, Safat, Kuwait.

Background: Post-hemorrhoidectomy anal stenosis though rare is very disturbing and devastating complication. Many surgical procedures have been described, but despite good results, many complications can ensue like flap necrosis, mucosal ectropion, and restenosis.

Objective: We report a new simple technique for repair of severe/moderate anal stenosis which requires no extensive flap mobilization or many sutures. Read More

Zhongguo Zhen Jiu 2017 Jul;37(7):747-752

Department of Acupuncture and Moxibustion.

Objective: To observe the regulatory effects of acupoint electric stimulation on the analgesic substances and the relevant indices of nerve-immunity-endocrine system in the patients undergoing general anesthesia anorectal operation.

Methods: One hundred and fifty-six patients undergoing hemorrhoids and anal fistula operation were randomized into three groups, 146 cases were included in the analysis. In the No. Read More

Dig Surg 2018 2;35(5):406-410. Epub 2017 Nov 2.

Background: Stapled anopexy is a safe technique for the treatment of hemorrhoids but carries a higher risk of recurrence, which might be caused due to the limited volume of resected tissue. In this study, we investigated the introduction of a high-volume circular stapling device; in particular whether an increased amount of resected tissue could affect patients' short-term postoperative outcome.

Methods: Between 2011 and 2015, stapled anopexy was performed for hemorrhoids and/or anal prolapse in 141 patients (n = 25 conventional PPH-3©-stapler versus n = 116 high-volume CHEX©-stapler). Read More

Ann Med Surg (Lond) 2017 Dec 16;24:31-33. Epub 2017 Oct 16.

University Department of Surgery, General and Oncologic Hospital of Kifissia ''Agii Anargiri'', Athens, Greece.

Hemorrhoids are a common anal disorder which affects both men and women of all ages. One out of ten patients with hemorrhoidal disease, requires surgical treatment. Unfortunately though, hemorrhoidectomy is closely related to complications that can be present early or late postoperatively. Read More

Surg Infect (Larchmt) 2017 Nov/Dec;18(8):924-928. Epub 2017 Oct 13.

2 Division of Colorectal Surgery, Drexel University College of Medicine , Philadelphia, Pennsylvania.

Background: With increased survival among patients with human immunodeficiency virus (HIV), surgeons have been seeing more cases of anal dysplasia and cancer. There is, however, no data on the incidence of surgical site infections (SSIs) in HIV-positive patients undergoing elective anorectal procedures, nor on the administration of prophylactic antibiotic agents. We reviewed a HIV-positive population that has undergone elective anorectal biopsy of areas of dysplasia observed on office anoscopy to assess the need for antibiotic prophylaxis. Read More

Turk J Surg 2017 1;33(3):190-194. Epub 2017 Sep 1.

Department of General Surgery, Ondokuz Mayıs University School of Medicine, Samsun, Turkey.

Objective: Hemorrhoidal disease is a very common entity in the general population; however, the therapeutic approaches to hemorrhoids remain controversial. The choice of treatment method depends on the grade of the hemorrhoid as well as the experience of the surgeon. The Whitehead hemorrhoidectomy procedure is often applied for grade IV hemorrhoids. Read More

Tech Coloproctol 2017 Sep 20;21(9):737-743. Epub 2017 Sep 20.

Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong, People's Republic of China.

Background: Tissue-selecting technique (TST) is a novel stapled hemorrhoidectomy technique which targets the hemorrhoids, leaving uninvolved mucosal bridges intact and avoiding circumferential circular stapling. The aim of this study was to compare the short-term outcomes of TST and transanal hemorrhoidal dearterialization (THD).

Methods: Patients presenting with symptomatic hemorrhoids were recruited. Read More

Surg Innov 2017 Dec 16;24(6):574-581. Epub 2017 Sep 16.

9 Yueyang Hospital of Hunan University of Traditional Chinese Medicine, Hunan, China.

Purpose: To explore the safety and efficacy of Ruiyun procedure for hemorrhoids (RPH) or RPH with the simplified Milligan-Morgan hemorrhoidectomy (sMMH) in the treatment of mixed hemorrhoids.

Methods: This is a randomized, controlled, balanced, multicenter study of 3000 patients with mixed hemorrhoids. The outcomes and postoperative complications were compared between 5 types of surgeries. Read More

Tech Coloproctol 2017 Aug 4;21(8):657-665. Epub 2017 Sep 4.

Department of Gastroenterological Surgery, Kameda Medical Center, Kamogawa City, Japan.

Background: The aim of the present study was to compare short- and medium-term results of transanal Doppler-guided hemorrhoidal dearterialization with mucopexy (DM) versus hemorrhoidectomy using an ultrasonic scalpel (US) for third-degree hemorrhoids.

Methods: Forty-four patients were randomly assigned to undergo either DM or US. The patients were followed up at 1, 2, 3 months at our clinic, and by telephone interview when the study was completed in May 2017. Read More

Rev Col Bras Cir 2017 May-Jun;44(3):278-283

Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brasil.

Objective:: to evaluate the impact of partial stapled hemorrhoidopexy on anorectal physiology, the complications related to this surgical technique, pain, postoperative bleeding and recurrence of hemorrhoidal disease one year after surgery.

Methods:: this is a prospective, descriptive study in consecutive patients with mixed or internal hemorrhoidal disease, the internal component being classified as grade III or IV, undergoing partial stapled hemorrhoidopexy.

Results:: we studied 17 patients, 82% of them with internal hemorrhoids grade III and 18% grade IV. Read More

Asian J Surg 2018 Sep 8;41(5):431-437. Epub 2017 Jul 8.

Division of Colorectal Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan; Graduate Institute of Cancer Biology and Drug Discovery, Taipei Medical University, Taipei, Taiwan; Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of General Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan; Cancer Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan; Translational Laboratory, Department of Medical Research, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan. Electronic address:

Background: Hemorrhoidectomy is commonly associated with postoperative pain. Calcium channel blockers are known to cause relaxation of gastrointestinal smooth muscle and oral diltiazem has also been shown to reduce the resting anal pressure.

Objective: We attempted to analyze efficacy and side effects of topical diltiazem oint. Read More

Asian J Endosc Surg 2018 Feb 6;11(1):60-63. Epub 2017 Jul 6.

Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.

A 65-year-old man presented with bloody stool. Colonoscopy revealed a raised tumor in the rectum, above the peritoneal reflection. He underwent endoscopic mucosal resection, but the pathological findings suggested the possibility of residual cancer. Read More

Medicine (Baltimore) 2017 Jun;96(26):e7309

Department of Anorectal Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

To compare the efficacy of homemade anal cushion suspension clamp combined with harmonic scalpel (ACS) and Milligan-Morgan hemorrhoidectomy combined with electric knife (MMH) in the treatment of stages III to IV hemorrhoids. We conducted a retrospective study of 99 patients with stages III to IV hemorrhoids hospitalized from January to December in 2013. Among them, 51 patients were treated with ACS, while 48 patients received MMH. Read More

Sao Paulo Med J 2017 May-Jun;135(3):247-252. Epub 2017 May 29.

MD, PhD. Professor, Department of Anesthesia, Universidade Federal de São Paulo (Unifesp), São Paulo (SP), Brazil.

Background And Objectives:: Postoperative analgesia and early recovery are important for hospital discharge. The primary objective of this study was to compare the analgesic effectiveness of perianal infiltration and subarachnoid anesthesia for hemorrhoidectomy. The secondary objective was to compare time to discharge, adverse effects and complications. Read More

Tech Coloproctol 2017 05 20;21(5):411-412. Epub 2017 May 20.

Colorectal Unit, Department of Surgery, Michallon University Hospital, CS 10217, 38043, Grenoble Cedex, France.

Tech Coloproctol 2017 May 27;21(5):337-344. Epub 2017 Apr 27.

Colorectal Unit, Department of General and Digestive Surgery, Bellvitge University Hospital, University of Barcelona, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.

Background: Distal Doppler-guided transanal hemorrhoidal dearterialization with mucopexy (Doppler-guided THD) seems to be associated with better short-term outcomes than conventional hemorrhoidectomy, but there are little data about long-term recurrence. The aim of this study was to compare Doppler-guided THD for grade III-IV hemorrhoids with conventional hemorrhoidectomy with regard to long-term postoperative morbidity and recurrence.

Methods: This was a single-center longitudinal and comparative study of a cohort of patients who underwent either distal Doppler-guided THD with low ligation of the hemorrhoidal artery and mucopexy or conventional excisional hemorrhoidectomy (Milligan and Morgan or Ferguson) for grade III and IV hemorrhoids. Read More

Surg Case Rep 2017 Dec 21;3(1):55. Epub 2017 Apr 21.

Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.

Anal metastasis of colorectal cancer is very rare and is usually associated with a history of anal disease, including anal fistula, fissure, hemorrhoidectomy, and anastomotic injury. We report a case of rectal cancer with a synchronous anal metastasis consisting of adenocarcinoma of squamous cells without a history of anal disease. A 60-year-old woman had a chief complaint of melena. Read More

Pak J Med Sci 2017 Jan-Feb;33(1):90-95

Prof. Fehmi Celebi, Department of General Surgery, Sakarya University Teaching and Research Hospital, Sakarya, Turkey.

Objective: To compare Ligation under Vision (LUV) with Ferguson Hemorrhoidectomy (FH) in patients with Grade II, III and IV hemorrhoidal diseases according to their postoperative outcomes.

Methods: Between July 2008 and August 2014, 155 patients underwent FH and 120 patients LUV, in Sakarya University Teaching and Research Hospital. Our retrospective analysis focuses on postoperative complications, postoperative pain and rate of recurrence. Read More

Australas J Dermatol 2017 Nov 17;58(4):308-311. Epub 2017 Feb 17.

Central Medical Laboratory, Manama, Kingdom of Bahrain.

In the last 16 years only seven definite cases of anal melanocytic naevi have been reported in the literature. We describe three new cases, none of which were suspected clinically and were incidentally diagnosed on histological examination of haemorrhoidectomy specimens. The infrequency of these special site flexural melanocytic lesions may be related to changes in the involutionary mechanisms of the anal melanocyte proliferation. Read More

Am J Surg Pathol 2017 Mar;41(3):382-388

Departments of *Pathology and Laboratory Medicine, Rhode Island Hospital †Pathology and Laboratory Medicine, Women and Infants Hospital of Rhode Island ‡Pathology and Laboratory Medicine §Pathology and Laboratory Medicine, The Miriam Hospital, Alpert Medical School of Brown University, Providence, RI.

Routine histopathologic examination of hemorrhoidectomy specimens is controversial having been described as not useful and expensive with few of these common cases demonstrating incidental lesions. However, unexpected premalignant and malignant lesions have been detected on excised hemorrhoids. The high-risk human papillomavirus (HR-HPV) types associated with these incidentally identified high-grade lesions are presently unknown. Read More

Klin Khir 2017(2):10-12

The treatment results in patients, suffering chronic hemorrhoidal disease stages III- IV, in accordance to the elaborated method of hemorrhoidectomy, using radio-wave scalpel «Surgitron TM» with further welding of vascular pedicle, applying high-frequency electrocoagulator ЕК-301М1, are presented. In the patients, оperated on in accordance to the method proposed, the intraoperative complications rate and the blood loss severity were essentially lesser than in a comparison group. Owing an adequate level of surgical skills, the operative treatment method elaborated guarantees the reduction of early and late postoperative morbidity, rapid coming back to routine way of living postoperatively. Read More

Int J Surg Case Rep 2017 15;30:73-75. Epub 2016 Nov 15.

Department of General Surgery, Vic University Hospital, Barcelona, Vic, Spain. Electronic address:

Introduction: Surgery is the only curative method of hemorrhoidal disease. Currently the Milligan-Morgan hemorrhoidectomy is still considered the "gold standard", since it is the best performing technique. However, postoperative pain remains a major problem. Read More

Tech Coloproctol 2016 Dec 25;20(12):825-833. Epub 2016 Nov 25.

Department of Coloproctology, First Affiliated Hospital of Zhejiang, Chinese Medical University, No. 54 Youdian Rd, Shangcheng District, Hangzhou, 310006, Zhejiang Province, People's Republic of China.

Background: The aim of this study was to analyse the outcomes of transanal hemorrhoidal dearterialization with mucopexy (THDm) versus open hemorrhoidectomy (OH) in the management of hemorrhoids.

Methods: Randomized controlled trials in English were found by searching PubMed, Web of science, EMBASE, and the Cochrane Library database. Trials that compared THDm with OH were identified. Read More

Minerva Chir 2016 Dec 4;71(6):365-371. Epub 2016 Nov 4.

Department of General and Emergency Surgery, Maggiore Polyclinic Hospital, Ca' Granda Foundation and Institute for Research and Care, Milan, Italy -

Background: This randomized study compared the medium-term results of stapled anopexy (SA) and transanal hemorrhoidal dearterialization with anopexy (THD) in 4 homogeneous groups of patients, 2 with third- and 2 with fourth-degree hemorrhoids.

Methods: Forty patients with third-degree and 30 with fourth-degree hemorrhoids were randomly submitted to SA (N.=20+15) and THD (N. Read More

Colorectal Dis 2017 Jun;19(6):559-562

Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, Bari, Italy.

Aim: The study aimed in a multicentric randomized controlled trial to define the role of a more extensive mucosal resection on recurrence of mucosal prolapse in patients with Stage III haemorrhoids undergoing stapled haemorrhoidopexy.

Method: In all, 135 patients were randomized to treatment with a PPH-01/03 (Ethicon EndoSurgery) or an EEA (Covidien) stapler. They were reviewed after a minimum follow-up of 4 years to determine the rate of recurrent mucosal prolapse and general condition (wellness evaluation score). Read More

J Thromb Thrombolysis 2017 Apr;43(3):423-425

Department of Surgery, The University of Arizona College of Medicine, Tucson, USA.

While topical thrombin application can markedly improve surgical hemostasis, rapid absorption of thrombin can result in pulmonary embolism and death. We report a case of accidental interstitial infiltration of topical thrombin after hemorrhoidectomy that was treated with administration of human antithrombin and heparin anticoagulation. Except for a marked decrease in antithrombin activity from super normal to normal values, the patient exhibited no laboratory or clinical signs of pulmonary embolism, thrombin mediated consumptive loss of procoagulants, or regional thrombosis. Read More

J Gastrointest Surg 2016 11 6;20(11):1886-1890. Epub 2016 Sep 6.

Department of Life, Health and Environmental Sciences MeSVA, University of L'Aquila, L'Aquila, Italy.

Introduction: The stapled hemorrhoidopexy (SH) and the Doppler-guided transanal hemorrhoidal dearterialization (DG-THD) are minimally invasive procedures for the surgical treatment of hemorrhoids. This study aims to verify the efficacy of the DG-THD versus the SH in the treatment of third-degree hemorrhoids.

Method: One hundred consecutive patients were causally allocated to either procedure, obtaining two groups of 50 pts. Read More

Cir Esp 2016 Dec 20;94(10):588-594. Epub 2016 Oct 20.

Clinic for Anesthesiology and Intensive Care, Military Medical Academy, Belgrado, Serbia.

Introduction: This prospective, observational study evaluated transanal dearterialization (THD) efficacy and safety in grade 2-4 hemorrhoids (HD).

Methods: THD was performed under sedation-locoregional anesthesia in 402 outpatients. Patients had follow-up evaluation 3 days, 2 weeks, 1, 6 and 12 months postoperatively. Read More

Minerva Gastroenterol Dietol 2017 Mar 21;63(1):44-49. Epub 2016 Oct 21.

Department of Surgery, University Hospital of Tor Vergata, Rome, Italy.

Background: Hemorrhoidectomy is considered the gold standard and the most effective and definitive treatment for grades 3 or 4 hemorrhoids, and Milligan-Morgan's and Ferguson's procedures are the most widely used techniques throughout the world. The aim of the study was to present our surgical technique using LigasureTM vessel sealing, focus on technical aspects and surgical tricks showing our results with a huge number of patients and a long-term follow-up.

Methods: Between June 2001 and June 2014 at the University Hospital of Tor Vergata, Rome, Italy, 1000 patients were selected to underwent LigasureTM hemorrhoidectomy for III and IV degree hemorrhoids. Read More

Acta Chir Belg 2016 Aug 18;116(4):213-216. Epub 2016 Aug 18.

a Department of General and Abdominal Surgery , AZ Turnhout , Turnhout , Belgium.

Background: A retrospective analysis was performed to assess differences between three devices used for stapled hemorrhoidopexy (SH) in terms of early complications and complaints and the volume of excised tissue.

Materials And Methods: All patients who underwent an elective SH from January 2008 to December 2014 were included. Three different devices were used: the PPH03 stapler (Ethicon EndoSurgery, Diegem, Belgium) and the Chex CPH32 and CPH34 staplers (Frankenman International Ltd, Hong Kong, China). Read More

Int J Colorectal Dis 2016 Jul 27;31(7):1261-72. Epub 2016 May 27.

General Surgery Department, Mansoura Faculty of Medicine, Mansoura University, Elgomhuoria Street, Mansoura city, Dakahlia providence, Egypt.

Background And Aim: Pain following hemorrhoidectomy is a distressing sequel to the procedure. Various methods have been used to alleviate post-hemorrhoidectomy pain; among these methods is the lateral internal sphincterotomy (LIS). This review aimed to analyze all studies that evaluated the impact of LIS on the outcome of excisional hemorrhoidectomy. Read More

Tech Coloproctol 2016 May 1;20(5):299-307. Epub 2016 Apr 1.

Proctology Unit, Department of Visceral Surgery, University Hospital, Geneva, Switzerland.

Background: As stapled hemorrhoidopexy (SH) becomes more widely used, we see more patients with chronic postoperative anal pain after this surgery. Its presentation is variable and difficult to treat. The aim of our study was to investigate the impact of chronic anal pain after SH and whether tailored therapy was likely to achieve a favorable outcome. Read More

J Ayub Med Coll Abbottabad 2015 Oct-Dec;27(4):791-3

Background: Haemorrhoids have been diagnosed and treated since the dawn of civilization, yet their cause, nature, symptomatology and especially their treatment options, remain hotly debated. The general principle however is that treatment should be directed by symptoms and the degree of haemorrhoids. The objective of the study is to compare early and late complications and wound healing time in open versus closed methods of haemorrhoidectomy. Read More

Rev Gastroenterol Mex 2016 Apr-Jun;81(2):74-9. Epub 2016 Mar 12.

Dirección de Investigación, Hospital Juárez de México, Ciudad de México, México.

Background: Anal sphincter spasm contributes to the appearance of postoperative pain following hemorrhoidectomy.

Aim: To determine the efficacy of topical diltiazem in the control of post-hemorrhoidectomy pain.

Material And Methods: A randomized, prospective, experimental, double-blind study was conducted on 2 groups of patients in the postoperative period of closed hemorrhoidectomy. Read More

Int J Surg 2016 Apr 10;28:39-44. Epub 2016 Feb 10.

Dept. of General and Digestive Surgery, Hospital Platón Barcelona, Universitat Autònoma Barcelona, c/ Platón 21, 08006 Barcelona, Spain.

Purpose: To analyse prospectively results of HAL-RAR technique by evaluating pain, perioperative complications and clinical outcome after two years followup.

Methods: A prospective study design including 30 consecutive patients with haemorrhoids grade III-IV treated from June 2012. After discharge, patients received a specific questionnaire to record postoperative pain, delayed complications, evolution/disappearance of the symptoms that led to the surgical intervention (bleeding, prolapse, itching, pain and soiling). Read More

Dis Colon Rectum 2016 Mar;59(3):230-5

1 Department of Surgery, Liv Hospital, Ankara, Turkey 2 Department of Surgery, Gazi University Medical School, Ankara, Turkey.

Background: Regarding anoplasty for anal stenosis, it is not clear to what extent the final anal caliber should be targeted.

Objective: The aim of this study was to investigate the results of diamond-flap anoplasty performed in a calibrated manner for the treatment of severe anal stenosis due to a previous hemorrhoidectomy.

Design And Setting: Prospectively prepared standard forms were evaluated retrospectively. Read More