The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
M Valente - One of the best experts on this subject based on the ideXlab platform.
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the Hemorrhoid laser procedure technique vs rubber band ligation a randomized trial comparing 2 mini invasive treatments for second and third degree Hemorrhoids
Diseases of The Colon & Rectum, 2011Co-Authors: P Giamundo, Raffaele Salfi, Maria Geraci, Livio Tibaldi, Luisa Murru, M ValenteAbstract:BACKGROUND:Hemorrhoid laser procedure is a new laser procedure for outpatient treatment of Hemorrhoids in which Hemorrhoidal arterial flow feeding the Hemorrhoidal plexus is stopped by means of Doppler-guided laser coagulation.OBJECTIVE:Our aim was to compare the Hemorrhoid laser procedure with rubb
Atsushi Okuzawa - One of the best experts on this subject based on the ideXlab platform.
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Treatment of Internal Hemorrhoids by Endoscopic Sclerotherapy with Aluminum Potassium Sulfate and Tannic Acid
Diagnostic and therapeutic endoscopy, 2015Co-Authors: Yuichi Tomiki, Jun Aoki, Rina Takahashi, Shun Ishiyama, Seigo Ono, Kiichi Sugimoto, Yukihiro Yaginuma, Yutaka Kojima, Michitoshi Goto, Atsushi OkuzawaAbstract:Objective. A new sclerosing agent for Hemorrhoids, aluminum potassium sulfate and tannic acid (ALTA), is attracting attention as a curative treatment for internal Hemorrhoids without resection. The outcome and safety of ALTA sclerotherapy using an endoscope were investigated in the present study. Materials and Methods. Subjects comprised 83 internal Hemorrhoid patients (61 males and 22 females). An endoscope was inserted and retroflexed in the rectum, and a 1st-step injection was applied to the upper parts of the Hemorrhoids. The retroflexed scope was returned to the normal position, and 2nd–4th-step injections were applied to the middle and lower parts of the Hemorrhoids under direct vision. The effects of endoscopic ALTA sclerotherapy were determined by evaluating the condition of the Hemorrhoids using an anoscope and interviewing the patient 28 days after the treatment. Results. A cure, improvement, and failure were observed in 54 (65.1%), 27 (32.5%), and 2 (2.4%) patients, respectively, treated with ALTA. Complications developed in 4 patients (mild fever in 3 and hematuria in 1). Recurrence occurred in 9.6%. Conclusions. The results of the present study suggest that endoscopic ALTA has the potential to become a useful and minimally invasive approach for ALTA sclerotherapy.
Richard A Malthaner - One of the best experts on this subject based on the ideXlab platform.
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stapled Hemorrhoidopexy is associated with a higher long term recurrence rate of internal Hemorrhoids compared with conventional excisional Hemorrhoid surgery
Diseases of The Colon & Rectum, 2007Co-Authors: Shiva Jayaraman, Patrick H D Colquhoun, Richard A MalthanerAbstract:PURPOSE: The purpose of this systematic review was to compare the long-term results of stapled Hemorrhoidopexy with conventional excisional Hemorrhoidectomy in patients with internal Hemorrhoids. METHODS: A systematic review of all randomized, controlled trials comparing stapled Hemorrhoidopexy and conventional Hemorrhoidectomy with long-term results was performed by using the Cochrane methodology. The minimum follow-up was six months. Primary outcomes were Hemorrhoid recurrence, Hemorrhoid symptom recurrence, complications, and pain. RESULTS: Twelve trials were included. Follow-up varied from six months to four years. Conventional Hemorrhoidectomy was more effective in preventing long-term recurrence of Hemorrhoids (odds ratio (OR), 3.85; 95 percent confidence interval (CI), 1.47-10.07; P<0.006). Conventional Hemorrhoidectomy also prevents Hemorrhoids in studies with follow-up of one year or more (OR, 3.6; 95 percent CI, 1.24-10.49; P<0.02). Conventional Hemorrhoidectomy is superior in preventing the symptom of prolapse (OR, 2.96; 95 percent CI, 1.33-6.58; P< 0.008). Conventional Hemorrhoidectomy also is more effective at preventing prolapse in studies with follow-up of one year or more (OR, 2.68; 95 percent CI, 0.98-7.34; P<0.05). Nonsignificant trends in favor of conventional Hemorrhoidectomy were seen in the proportion of asymptomatic patients, bleeding, soiling/difficultly with hygiene/incontinence, the presence of perianal skin tags, and the need for further surgery. Nonsignificant trends in favor of stapled Hemorrhoidopexy were seen in pain, pruritus ani, and symptoms of anal obstruction/stenosis. CONCLUSIONS: Conventional Hemorrhoidectomy is superior to stapled Hemorrhoidopexy for prevention of postoperative recurrence of internal Hemorrhoids. Fewer patients who received conventional Hemorrhoidectomy complained of Hemorrhoidal prolapse in long-term follow-up compared with stapled Hemorrhoidopexy.
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stapled Hemorrhoidopexy is associated with a higher long term recurrence rate of internal Hemorrhoids compared with conventional excisional Hemorrhoid surgery
Diseases of The Colon & Rectum, 2007Co-Authors: Shiva Jayaraman, Patrick H D Colquhoun, Richard A MalthanerAbstract:PURPOSE: The purpose of this systematic review was to compare the long-term results of stapled Hemorrhoidopexy with conventional excisional Hemorrhoidectomy in patients with internal Hemorrhoids. METHODS: A systematic review of all randomized, controlled trials comparing stapled Hemorrhoidopexy and conventional Hemorrhoidectomy with long-term results was performed by using the Cochrane methodology. The minimum follow-up was six months. Primary outcomes were Hemorrhoid recurrence, Hemorrhoid symptom recurrence, complications, and pain. RESULTS: Twelve trials were included. Follow-up varied from six months to four years. Conventional Hemorrhoidectomy was more effective in preventing long-term recurrence of Hemorrhoids (odds ratio (OR), 3.85; 95 percent confidence interval (CI), 1.47-10.07; P<0.006). Conventional Hemorrhoidectomy also prevents Hemorrhoids in studies with follow-up of one year or more (OR, 3.6; 95 percent CI, 1.24-10.49; P<0.02). Conventional Hemorrhoidectomy is superior in preventing the symptom of prolapse (OR, 2.96; 95 percent CI, 1.33-6.58; P< 0.008). Conventional Hemorrhoidectomy also is more effective at preventing prolapse in studies with follow-up of one year or more (OR, 2.68; 95 percent CI, 0.98-7.34; P<0.05). Nonsignificant trends in favor of conventional Hemorrhoidectomy were seen in the proportion of asymptomatic patients, bleeding, soiling/difficultly with hygiene/incontinence, the presence of perianal skin tags, and the need for further surgery. Nonsignificant trends in favor of stapled Hemorrhoidopexy were seen in pain, pruritus ani, and symptoms of anal obstruction/stenosis. CONCLUSIONS: Conventional Hemorrhoidectomy is superior to stapled Hemorrhoidopexy for prevention of postoperative recurrence of internal Hemorrhoids. Fewer patients who received conventional Hemorrhoidectomy complained of Hemorrhoidal prolapse in long-term follow-up compared with stapled Hemorrhoidopexy.
Alfred Rimm - One of the best experts on this subject based on the ideXlab platform.
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optimal nonsurgical treatment of Hemorrhoids a comparative analysis of infrared coagulation rubber band ligation and injection sclerotherapy
The American Journal of Gastroenterology, 1992Co-Authors: John F Johanson, Alfred RimmAbstract:Despite an abundance of nonsurgical Hemorrhoid therapies, none has been consistently more efficacious. By combining data from multiple clinical trials in a meta-analysis, the present study compared the efficacy and complications of infrared coagulation, injection sclerotherapy, and rubber band ligation to determine the optimal nonoperative Hemorrhoid treatment. All published clinical trials comparing the three methods were identified by computer search and review of appropriate English language journals. Five trials studying 863 patients satisfied all inclusion criteria. Results demonstrated that similar numbers of patients were asymptomatic 12 months after treatment, regardless of initial therapy. However, significantly fewer patients undergoing rubber band ligation required additional treatment because symptoms had recurred. Although rubber band ligation demonstrated greater long-term efficacy, it was associated with a significantly higher incidence of posttreatment pain. In contrast, infrared coagulation was associated with both fewer and less severe complications. Thus, when all factors are considered, infrared coagulation may in fact be the optimal nonoperative Hemorrhoid treatment.
R Farouk - One of the best experts on this subject based on the ideXlab platform.
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doppler guided Hemorrhoid artery ligation reduces the need for conventional Hemorrhoid surgery in patients who fail rubber band ligation treatment
Diseases of The Colon & Rectum, 2009Co-Authors: Philip Conaghan, R FaroukAbstract:PURPOSE:This study was designed to assess whether Doppler-guided Hemorrhoid artery ligation can prevent patients from needing conventional surgery when rubber band ligation of their Hemorrhoids has failed to achieve symptomatic relief.METHODS:All patients who underwent treatment for Hemorrhoids in t
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sustained internal sphincter hypertonia in patients with chronic anal fissure
Diseases of The Colon & Rectum, 1994Co-Authors: R Farouk, G S Duthie, A B Macgregor, D C C BartoloAbstract:PURPOSE: This study was designed to determine whether functional variations of internal sphincter activity occur in order to differentiate between patients with anal fissures from those with Hemorrhoids. METHODS: Thirty patients with chronic anal fissure (median age, 28 years; 12 females), 22 patients with Hemorrhoids (median age, 37 years; 7 females), and 33 control volunteers (median age, 48.5 years; 21 females) underwent ambulatory anal sphincter fine-needle electromyography and anorectal manometry. RESULTS: The median internal sphincter electromyography frequency was similar: fissure group, 0.49 Hz; Hemorrhoid group, 0.46 Hz (P>0.05), and control group, 0.44 Hz (P>0.05). Median anal resting pressures were similar in the fissure group (132 cm. H2O) and the Hemorrhoids group (116 cm of H2O) (P>0.05), but significantly greater than those in the control group (94 cm. H2O) (P 0.1vs.controls) and the number of internal sphincter relaxations increased to 4 per hour (P<0.01vs.preoperative number). CONCLUSIONS: Internal anal sphincter relaxation occurs on fewer occasions in patients with chronic anal fissures that have failed to heal in comparison to patients with Hemorrhoids and normal controls. This evidence further supports the hypothesis that internal sphincter hypertonia may be relevant to the pathogenesis of this disorder.