Hemorrhoids and Fistulas: New Solutions to Old Problems

Rakinic, Jan; Poola, V. Prasad

doi:10.1067/j.cpsurg.2013.11.002

Cited by 62 publications

(29 citation statements)

References 164 publications

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“…The anal mucosa can also be fixed to the internal sphincter by including small bites of the muscle. Suturing continues out onto the perianal skin to produce a longitudinal suture line, leaving a 5-mm opening for drainage [40]. The procedure is repeated until all haemorrhoids have been dealt with.…”

Section: Closed (Ferguson) Haemorrhoidectomymentioning

confidence: 99%

Still a Case of “No Pain, No Gain”? An Updated and Critical Review of the Pathogenesis, Diagnosis, and Management Options for Hemorrhoids in 2020

Young

2020

Ann Coloproctol

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The treatment of haemorrhoids remains challenging: multiple treatment options supported by heterogeneous evidence are available, but patients rightly demand a tailored approach. Evidence for newer surgical techniques that promise to be less painful has been conflicting. We review the current evidence for management options in patients who present with varying haemorrhoidal grades. A review of the English literature was performed utilizing MEDLINE/PubMed, Embase, and Cochrane databases (31 May 2019). The search terms (haemorrhoid OR haemorrhoid OR haemorrhoids OR haemorrhoids OR “Hemorrhoid”[Mesh]) were used. First- and second-degree haemorrhoids continue to be managed conservatively. The easily repeatable and cost-efficient rubber band ligation is the preferred method to address minor haemorrhoids; long-term outcomes following injection sclerotherapy remain poor. Conventional haemorrhoidectomies (Ferguson/Milligan-Morgan/Ligasure haemorrhoidectomy) still have their role in third- and fourth-degree haemorrhoids, being associated with lowest recurrence; nevertheless, posthaemorrhoidectomy pain is problematic. Stapled haemorrhoidopexy allows quicker recovery, albeit at the costs of higher recurrence rates and potentially serious complications. Transanal Haemorrhoidal Dearterialization has been promoted as nonexcisional and less invasive, but the recent HubBLe trial has questioned its overall place in haemorrhoid management. Novel “walk-in-walk-out” techniques such as radiofrequency ablations or laser treatments will need further evaluation to define their role in modern-day haemorrhoid management. There are numerous treatment options for haemorrhoids, each with their own evidence-base. Newer techniques promise to be less painful, but recurrence rates remain an issue. The balance continues to be sought between long-term efficacy, minimisation of postoperative pain, and preservation of anorectal function.

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Section: Closed (Ferguson) Haemorrhoidectomymentioning

confidence: 99%

Still a Case of “No Pain, No Gain”? An Updated and Critical Review of the Pathogenesis, Diagnosis, and Management Options for Hemorrhoids in 2020

Young

2020

Ann Coloproctol

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“…An external fistula is defined as one that connects an internal organ and the skin surface [3]. According to the most widely accepted definition, an anal fistula is an external fistula that creates an abnormal connection between the anorectum and perianal epithelium [4][5][6][7]. Anal fistulas are associated with significant clinical manifestations (e.g., local pain, phlogosis, purulent drainage, and incontinence) and impaired health-related quality of life [6].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Anal Fistulas in Europe: Systematic Literature Reviews and Population-Based Database Analysis

Garcı́a-Olmo

Assche

Tagarro³

et al. 2019

Adv Ther

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Introduction: Despite the fact that perianal fistulas are associated with significant morbidity and impaired quality of life, their prevalence in Europe is unknown. The aim of this study was to estimate the prevalence of perianal fistulas in Europe, overall and according to etiology. Methods: Two independent literature reviews were performed using different search strategies to maximize the identification of potentially relevant studies. Data from relevant articles were used to estimate the prevalence of perianal fistulas in Europe. The robustness of the estimate was evaluated using data from a large population-based database from the UK. Results: A total of 26 studies provided epidemiological data on perianal fistulas, of which 16 provided suitable data to estimate the prevalence. Estimations using these data yielded a total prevalence of 1.69 per 10,000 population. Cryptoglandular infection and Crohn's disease (CD) were the predominant etiologies, with prevalence rates at 0.86 and 0.76 per 10,000 population, respectively. Comparison of prevalence data from the UK population-based database with the European population resulted Enhanced Digital Features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.9948788.

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“…5 Anal pain and discomfort, itching, bleeding, swelling, and perceived mass in the perianal zone are considered as the main symptoms of hemorrhoids. 6 , 7 …”

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confidence: 99%

An Evidence-Based Study on Medicinal Plants for Hemorrhoids in Medieval Persia

Hashempur

Khademi

Rahmanifard

et al. 2017

J Evid Based Complementary Altern Med

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Hemorrhoids is one of the most common gastrointestinal diseases. There are several therapeutic options associated with some complications. Therefore, researchers look for traditional medicines as a potential resource for introduction of new natural drugs. The current study reports an evidence-based review of herbal remedies for hemorrhoids in traditional Persian medicine. A comprehensive survey about hemorrhoids on the most important manuscripts of traditional Persian medicine was done. Then, scientific data banks were searched for possible related properties of each herb in the conventional medicine. We reported some historical aspects of traditional Persian medicine view on classification, examination, and predisposing factors of hemorrhoids. In addition, we have reported 105 medicinal plants belonging to 51 families. More than half of the reported herbs exhibited anti-inflammatory and analgesic effects. Although lack of human studies regarding the mentioned herbs is noted, positive results from experimental findings can be considered for new drug discovery supported by traditional and medieval experiences.

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Hemorrhoids and Fistulas: New Solutions to Old Problems

Cited by 62 publications

References 164 publications

Still a Case of “No Pain, No Gain”? An Updated and Critical Review of the Pathogenesis, Diagnosis, and Management Options for Hemorrhoids in 2020

Still a Case of “No Pain, No Gain”? An Updated and Critical Review of the Pathogenesis, Diagnosis, and Management Options for Hemorrhoids in 2020

Prevalence of Anal Fistulas in Europe: Systematic Literature Reviews and Population-Based Database Analysis

An Evidence-Based Study on Medicinal Plants for Hemorrhoids in Medieval Persia

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