Minimal Open Hemorrhoidectomy Versus Transanal Hemorrhoidal Dearterialization: The Effect on Symptoms: An Open-Label Randomized Controlled Trial

BACKGROUND: There is limited evidence on the long-term efficacy of transanal hemorrhoidal dearterialization compared with hemorrhoidectomy. Most studies investigated short-term effects with postoperative pain as the primary outcome. Being a benign disease, the long-term goal of treatment for hemorrhoids is the resolution of symptoms and improvement of quality of life. OBJECTIVE: The purpose of this study was to compare the effect of minimal open hemorrhoidectomy versus transanal hemorrhoidal dearterialization on patient-reported symptoms. DESIGN: This was an open-label randomized controlled trial. SETTINGS: This was a single-center study. PATIENTS: Patients with symptomatic hemorrhoids grade II to IV (Goligher’s classification) were included. INTERVENTIONS: Patients were randomly allocated to minimal open hemorrhoidectomy or transanal hemorrhoidal dearterialization. MAIN OUTCOME MEASURES: The primary outcome was symptoms assessed by the Hemorrhoidal Disease Symptom Score 1 year postoperatively. Secondary outcomes included health-related quality of life, patient satisfaction, postoperative pain and recovery, adverse events, recurrence, and hospital costs. RESULTS: Forty-eight patients received minimal open hemorrhoidectomy, and 50 patients received transanal hemorrhoidal dearterialization. No difference in symptom score at 1-year follow-up was found. Median (range) symptom score was 3 (0–17) after minimal open hemorrhoidectomy and 5 (0–...
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Original Contributions: Anorectal Source Type: research

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Source: FDA Center for Drug Evaluation and Research - What's New - Category: Drugs & Pharmacology Authors: Source Type: news
Abstract Phlebotonics' effects were evaluated to reduce time-to-stop bleeding and anal irritation in 130 patients who complained of hemorrhoidal disease (HD); bleeding and pain after hemorrhoidectomy (31 patients) and hemorrhoidal thrombosis (34 patients) in the short time. Sixty patients were randomized to receive the routine treatment (both conservative and surgical) (control Group C). The treated group (both conservative and surgical) was divided into two subgroups: one treated with flavonoids (Group A, n = 73), the other with Centella (Group B, n = 66). Time-to-stop bleeding was che...
Source: Anal Sci - Category: Chemistry Authors: Tags: Sci Rep Source Type: research
AbstractIntroductionHemorrhoidal disease (HD) is a common and recurrent problem for many adults worldwide. Venoactive drugs, such as micronized purified flavonoid fraction (MPFF; Daflon®), have been used to treat HD and their clinical benefits have been demonstrated in previous meta-analyses of clinical trials. The aim of this study was to evaluate the efficacy of MPFF across the broader spectrum of signs and symptoms following treatment of patients with HD.MethodsWe performed a systematic review of the literature to identify randomized clinical trials in which MPFF treatment was compared to placebo or no treatment for...
Source: Advances in Therapy - Category: Drugs & Pharmacology Source Type: research
Abstract 1. INTRODUCTION Hemorrhoids are vascular cushions underlying the distal rectal mucosa and contributing for approximately 15-20% of the resting anal pressure with a complete closure of the anal canal. They can become pathological (hemorrhoidal disease, HD) being the most common cause of painless rectal bleeding during defecation with or without prolapsing anal tissue1 . In this case the blood is bright red, not mixed with faeces but instead coated on their outer surface, or dropping after bowel movement. HD is generally classified by its location in internal (originated above the dentate line and covered b...
Source: Reviews on Recent Clinical Trials - Category: Cancer & Oncology Authors: Tags: Rev Recent Clin Trials Source Type: research
Conditions:   Bleeding Anal;   Pain;   Stings Interventions:   Drug: Vitamin E ovules;   Drug: Prednisolone ointment Sponsor:   Hospital General Universitario Elche Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Authors: Lobascio P, Laforgia R, Novelli E, Perrone F, Di Salvo M, Pezzolla A, Trompetto M, Gallo G Abstract Background: Hemorrhoidal disease (HD) is defined as the symptomatic enlargement and/or distal displacement of anal cushions and is one of the most common proctological diseases. Sclerotherapy (ST) with 3% polidocanol foam induces an inflammatory reaction with sclerosis of the submucosal tissue and consequent suspension of the hemorrhoidal tissue. The aim of this study was to evaluate the short-term effectiveness and safety of ST with 3% polidocanol foam for the treatment of symptomatic second- and third-degr...
Source: Journal of Investigative Surgery - Category: Surgery Tags: J Invest Surg Source Type: research
Abstract Anal post-operative pain is one of the principal issues of surgical treatment of hemorrhoids and remains a distressing problem, for patients and physicians. Recent studies had concluded that appropriate postoperative pain management lead to higher patient satisfaction, earlier mobilization, fewer drug complications, eliminated adverse events, faster recovery, and decreased health care cost. However, despite advances in pain medicine, postoperative pain control remains problematic and remains an important unresolved issue that causes expense and patient dissatisfaction. Therefore this situation calls for m...
Source: Reviews on Recent Clinical Trials - Category: Cancer & Oncology Authors: Tags: Rev Recent Clin Trials Source Type: research
CONCLUSIONS: Pain, urinary retention and bleeding remain the most frequent complications after surgery for hemorrhoids; however, special situations must be taken into account in order to choose the best technique to prevent more severe complications. PMID: 32250228 [PubMed - as supplied by publisher]
Source: Reviews on Recent Clinical Trials - Category: Cancer & Oncology Authors: Tags: Rev Recent Clin Trials Source Type: research
In this study, we hypothesize that increasing patients' awareness of hidden risk factors could reduce the rate of HD and AF. MATERIALS AND METHODS: A questionnaire-based controlled study was planned. After power analysis, patients with HD (n=60) and AF (n=60) were enrolled consecutively into the study group and compared with the control group (n=60) of healthy individuals. The survey was designed to assess the participants' toilet and dietary habits and anxiety risk. Odds ratios were calculated and a binary logistic regression model was constructed to identify associated factors. RESULTS: Hard stools, spending mo...
Source: The Turkish Journal of Gastroenterology - Category: Gastroenterology Authors: Tags: Turk J Gastroenterol Source Type: research
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