Hemorrhoidectomy In Treatment Research Articles

Laser hemorrhoidoplasty versus LigaSure™ hemorrhoidectomy versus diathermy hemorrhoidectomy in treatment of grade III and IV Hemorrhoids: A non-randomized prospective trial

BackgroundThrough the past decades, various surgical methods have been introduced as new modalities for the management of grade III and IV hemorrhoidal disease HD, to provide an effective and less invasive operation in comparison with conventional haemorrhoidectomy which is the gold standard surgical treatment. MethodsThis study was conducted at Alexandria Main University Hospital. Ninety three patients with grade III and IV HD were enrolled in our study, thirty-one patients treated with diathermy hemorrhoidectomy DH (group A), thirty-one patients with LigaSure™ hemorrhoidectomy LH (group B),and thirty-one patients with Laser hemorrhoidoplasty LHP (group C). Assessment of postoperative pain, intra and postoperative bleeding, operative time, time to return to work, quality of life using Hemorrhoidal Disease Symptom Score HDSS, and Short Health Scale for hemorrhoidal disease SHSHD and patient satisfaction were recorded and analyzed. ResultsThe postoperative pain according to Visual analogue scale VAS scores from the evening of the procedure till the fourth week postoperatively were significantly higher in group A patients compared to group B and C patients, however, no significant statistical difference was found between group B and C patients. There was significant statistical difference between each group for intra-operative bleeding, operative time, and time to return to work with advantage for LHP. LH led to significant improvement in both HDSS, SHSHD when compared with LHP (p = 0.015*and p = p3<0.001*respectively) and when compared with DH, however, only SHSHD was statistical significance (p = 0.001*). The median score for patient satisfaction was 6 in the 3 groups (range: 3–7 group A, 3–7 group B and 2–6 group C) with no statistical significance. ConclusionLH and LHP are associated with significantly less postoperative pain and give superior results than DH in terms of less operative time, intraoperative blood loss, postoperative complications, and faster recovery time, with significantlys better health-related quality of life after LH.

Evaluation of Laser Pile Surgery versus Ligasure Hemorrhoidectomy in Treatment of Hemorrhoids

Evaluation of Laser Pile Surgery versus Ligasure Hemorrhoidectomy in Treatment of Hemorrhoids

The Clinical Efficacy of Infrared Photocoagulation Versus Closed Hemorrhoidectomy in Treatment of Hemorrhoid.

Introduction: Infrared photocoagulation (IRC) was introduced as a mainstay procedure for treatment of hemorrhoids. The present study aimed to compare the clinical efficacy of IRC compared to closed hemorrhoidectomy. Methods: Forty patients suffering grade-3 hemorrhoid that referred to the surgery clinic at Imam Hossein hospital in Tehran in 2013 were randomly assigned to groups treated with the IRC modality or Ferguson's closed hemorrhoidectomy method. The patients in the 2 groups were followed-up for the first 24 hours after surgery and 8 weeks later. Postoperative pain was assessed using visual analogue scale (VAS) at three time points of 24 hours, 2 weeks and 8 weeks after operation. Results: Regarding bleeding, its overall prevalence was 5.0% in the IRC group and 30.0% in the hemorrhoidectomy group, which was significantly less prevalent in the IRC group. Notably, the IRC group had a lower mean postoperative pain score compared to the hemorrhoidectomy group. Time of return to work was significantly shorter in the IRC group; no difference was found in the mean duration of hospital stay, and recurrence rate across 2 groups. Conclusion: IRC procedure is safer than closed hemorrhoidectomy with lower postoperative pain severity, less secondary bleeding, and leads to earlier return to work in patients with hemorrhoid.

Comparative Study of Staging Rubber Band Ligation (RBL) and Hemorrhoidectomy in Treatment of Forth Degree Hemorrhoids

Background: Rubber band ligation is one of the most worldwide used treatments of hemorrhoids because of its effectiveness and low complication rate. Hemorrhoidectomy is the procedure of choice for treatment of grade four hemorrhoids which is a painful method for a relatively benign disease. There are a few studies available analyzing the effectiveness of RBL as an initial treatment for grade four symptomatic internal hemorrhoids. Objective: This study aimed to analyze the efficacy of the staging rubber band ligation in treatment of grade four hemorrhoids and comparing to hemorrhoidectomy. Patients and Methods: A prospective randomized clinical trial was performed on all patients diagnosed with grade four symptomatic internal hemorrhoids from August 2011 to March 2013. Sixty four patients with grade four hemorrhoids were divided into two groups and underwent hemorrhoidectomy (H group) and rubber band ligation (R group).These patients were compared for any complications and recurrence in a six month period. Results: Pain existed in 100% of the H group and 67.7% of the R group in the first visit one week postoperation (P < 0.05). There was a statistically significant difference between the two groups regarding the days off work. Patients’ satisfaction and recurrence were similar in both groups after a period of six months. Conclusions: This study showed that staging rubber band ligation is effective for treating grade four hemorrhoids. Few complication and low recurrence rate were noted which enable us to recommend this modality as the procedure of choice for the management of selected patients with grade four symptomatic hemorrhoids.

Comparison of two-year efficacy between procedure for prolapse and hemorrhoids and Milligan-Morgan hemorrhoidectomy in treatment of III and IV degree internal hemorrhoids

To compare the long-term efficacy of procedure for prolapse and hemorrhoids (PPH) and Milligan-Morgan hemorrhoidectomy (MMH) in the treatment of III and IV degree internal hemorrhoids. One hundred patients were randomly divided into two groups and received PPH (n=42) and MMH (n=58) respectively. After two years, the efficacy, complications and function of defecation were compared. Two years after operation, the morbidities of hydrorrhea (2.38% vs 20.69%, P=0.007), dermal neoplasm formation (9.52% vs 25.86%, P=0.040) and narrowing in the caliber of the stools (2.38% vs 18.97%, P=0.027) were significantly lower in PPH group than those in MMH group (P<0.05). The morbidities of overall complication (9.52% vs 25.86%, P=0.040) and overall abnormal function of defecation (9.52% vs 29.31%, P=0.017) were lower in PPH group than those in MMH group (P<0.05). However, there were no significant differences of the morbidity of relapse (14.29% vs 10.34%, P=0.549), patient satisfactory degree (92.86% vs 87.93%, P=0.636) and overall symptom recurrence rate (19.05% vs 25.86%, P=0.424) between the two groups. Long-term efficacies of procedure for prolapse and hemorrhoids and Milligan-Morgan haemorrhoidectomy in the treatment of III and IV degree internal hemorrhoids are similar. PPH has better safety, less complications and less effect on abnormal function of defecation compared with MMH.