Title of article :
Excision Hemorrhoidectomy: New Methods to Improve the Outcomes of an Old Technique
Author/Authors :
Heng، Gregory نويسنده Department of Surgery, Khoo Teck Puat Hospital, Yishun, Singapore , , Yang Tan، Kok نويسنده Department of Surgery, Khoo Teck Puat Hospital, Yishun, Singapore ,
Issue Information :
فصلنامه با شماره پیاپی 29 سال 2016
Abstract :
Abstract
Context: Hemorrhoidal disease is the most common anorectal disorder that requires surgical intervention. Hemorrhoids require
treatment when they result in symptoms such as bleeding or prolapse. Surgical intervention is indicated for significant prolapse,
and a number of accepted and viable methods are available for treating prolapsing hemorrhoids that do not reduce spontaneously
(Grade III and IV). Excision hemorrhoidectomy remains the gold standard treatment for Grade III and IV hemorrhoids despite great
interest in alternative procedures such as stapled hemorrhoidopexy and Doppler-guided hemorrhoidal artery ligation with mucopexy.
A large body of evidence demonstrates that excision hemorrhoidectomy is an effective, safe, and affordable procedure.
Nevertheless, the main drawback of excision hemorrhoidectomy remains its notorious association with significant postoperative
pain.
Evidence Acquisition: A comprehensive literature search was conducted through MEDLINE and the Cochrane database of systematic
reviews. Only prospective case-controlled studies, review articles, and meta-analyses were considered.
Results: Manystrategies have been put forward in the literature to address the issue of pain after excision hemorrhoidectomy. These
strategies can be broadly categorized into surgical techniques (e.g., LigaSure hemorrhoidectomy) and pharmacological adjuncts
(e.g., intradermal methylene blue and chemical sphincterotomy with glyceryl trinitrate ointment). In recent years, meta-analyses
and randomized controlled trials have been performed to evaluate their effects.
Conclusions: This article evaluates the evidence behind these strategies and outlines the new methods available to improve the
outcomes of an old technique.
Journal title :
Astroparticle Physics