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. Follow-up evaluation was performed at 15 days, 30 days, 6 months, 12 months, and then annually. Pain was measured using a Visual Analogic Scale and was self-recorded by patients. Quality of life was measured with Short Form Survey-36 questionnaire. Results. Postoperative pain was lower in the HAL-RAR group during the first 30 postoperative days. Moreover, from day 7 onward more patients in the HAL-RAR group reported complete absence of pain (Visual Analogic Scale score = 0). Globally, symptom resolution was significantly higher (P = .03) in the HAL-RAR group at day 15. Bleeding resolution was observed earlier in the HAL-RAR group than in the EH group (P = .04), but no differences in the resolution of prolapse, itching, and soiling were observed during the 30-day follow-up. After a mean follow-up of 15 months (range 12-27 months), no differences in postoperative morbidity and no recurrences were observed. An improvement was observed in all sections evaluated by the Short Form Survey-36 questionnaire with both techniques. Conclusion. HAL-RAR provokes less postoperative pain during a shorter period than EH and achieves resolution of hemorrhoidal symptoms with less postoperative complaints. No differences in morbidity and recurrence rate were observed after 12 months of follow-up.
Aim Sublay mesh placement in incisional hernia repair (IH) does not seem to show lower surgical site infection (SSI) or recurrence than onlay placement, according to a recent review. Our aim was to analyze both techniques in an abdominal wall department. Material and Methods Prospective data collection of all IHs for four years. Results were analyzed at one month and during follow-up. The characteristics of IH, operative time, incidence of SSI and recurrence was compared by groups depending on location of the mesh in sublay (SM) or onlay (OM). Results “The surface area of the hernial defect was greater in the SM group (216±338 vs 68±84cm2; P = 0.002), as well as longer surgical time (131±91 vs 70±54 min; P < 0.001). A higher number of hematoma was diagnosed in the SM (OR 1.39; CI95% 1.21-1.60; P = 0.18) in 88 operations. No differences were observed in the incidence of SSI between the groups (27.7 vs 21.7%; P = 0.78). 74 patients completed a mean follow-up of 11.4 months, any difference in IH recurrence appeared (5.8 vs 9.1%; P = 0.63) in SM group vs OM group, respectively. Conclusions A SM repair is performed in IHs with large defects, which entails a longer surgical time and the appearance of hematoma, although no statistically significant differences in the rate of SSI or IH recurrence was observed between SM and OM repair.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.