Comparison of the efficacy and safety of different surgical procedures for patients with hemorrhoids: a network meta-analysis

Yuan, Xue Gang; Wu, Jia; Yin, Hong Mei; Ma, Chuan Ming; Cheng, Si Jun

doi:10.1007/s10151-023-02855-6

Cited by 2 publications

(4 citation statements)

References 45 publications

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“…Our current PPH data were 6.7% compared with no case in Hemorrhoidectomy. However, the latest study of network meta-analysis demonstrated that PPH is best at reducing postoperative anal stricture and suggests that PPH has the least anal stenosis [ 17 ]. Compared with this inconsistent analysis, there are many possibilities to explain the current different conclusions in the incidence rate of anatomical anal stenosis, including the grade of hemorrhoids, placement of incision, the type of suture, and the experience of surgeon in hemorrhoidectomy.…”

Section: Discussionmentioning

confidence: 99%

“…Three systematic review articles demonstrated that PPH, compared to conventional surgery, has a higher risk for poor long-term outcomes and increased incidence of anal stenosis [ 14 , 15 , 16 ]. A recent study of network meta-analysis demonstrated that PPH is best at reducing postoperative anal stricture and suggests that PPH has the least anal stenosis [ 17 ]. A study demonstrated excised specimens not only include the mucosa and submucosa, but also the anal sphincter [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Anatomical Anal Stenosis after PPH: Insights from a Retrospective Study and Rat Model

Wen,

Huang,

Wang

2024

IJMS

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High-grade hemorrhoids are usually recommended to receive operational treatments. However, these traditional surgeries are associated with severe postoperative pain. A procedure for prolapse and hemorrhoids (PPH), a circular staple device, has been developed to improve short-term outcomes, including reducing the severity of postoperative pain. PPH, compared to conventional surgery, has been associated with the incidence of anatomical anal stenosis. The causes of stenosis after PPH are not yet clear. We first analyzed the complications of our patients with PPH, and then developed a rat model to verify the tension force of PPH using Hematoxylin-eosin, Masson’s trichrome, immunohistochemistry, and immunofluorescence staining. Our clinical data showed that PPH significantly improved postoperative pain, but that it resulted in higher incidences of complications, including anal stenosis, than hemorrhoidectomy. We simulated the status of PPH and developed a rat model to verify PPH’s tension force, including the scarring area and the deposition of proinflammatory factors, angiogenic factors, and fibrotic factors. The tension wound histological data showed more extensive granulation tissue and inflammatory cell infiltration and a thicker epidermis than the control group on day 12 post-operation and tension treatment. In addition to IL-1β and IL-10 cytokines on day 3 and IL-1β, IL-6, and IL-10 cytokines on day 12 post-operation in the tension group, two angiogenic factors, CD31 and VEGF-A, were found to have a more significant expression on day 7 post-operation in the tension group. The mean scar area was larger and the distribution of fibrotic proteins (collagen 1, α-SMA, CTGF, and MMP2) in the tension group was significantly broader than in the control on day 12 post-operation and tension treatment. Based on the findings of our animal model, the development of a lesser tensile force for PPH to decrease the deposition of proinflammatory factors, angiogenic factors, and fibrotic factors is urgently required.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Anatomical Anal Stenosis after PPH: Insights from a Retrospective Study and Rat Model

Wen,

Huang,

Wang

2024

IJMS

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“…Open haemorrhoidectomy in stage III-IV haemorrhoids remains one of the most effective treatment methods [1][2][3][4]. The use of different…”

Section: Seamless Open Excisional Haemorrhoidectomy-six Faces Of Surg...mentioning

confidence: 99%

“…surgical instruments in open haemorrhoidectomy may affect postoperative outcomes as well as operating time [3]. We present a step-bystep open haemorrhoidectomy technique for the surgical treatment of grade III-IV haemorrhoidal disease using different instruments.…”

Section: Seamless Open Excisional Haemorrhoidectomy-six Faces Of Surg...mentioning

confidence: 99%

Seamless open excisional haemorrhoidectomy—Six faces of surgical technique: A Video Vignette

Efetov,

Otabekov,

Koziy

2024

Colorectal Disease

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Comparison of the efficacy and safety of different surgical procedures for patients with hemorrhoids: a network meta-analysis

Cited by 2 publications

References 45 publications

Anatomical Anal Stenosis after PPH: Insights from a Retrospective Study and Rat Model

Anatomical Anal Stenosis after PPH: Insights from a Retrospective Study and Rat Model

Seamless open excisional haemorrhoidectomy—Six faces of surgical technique: A Video Vignette

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