Immediate Hæmorrhoidectomy for Prolapsed Piles

Tinckler, LaurenceF.; Baratham, Gopal

doi:10.1016/s0140-6736(64)92667-4

Cited by 33 publications

(6 citation statements)

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“…There were many more men than women in this series and this predominance has been reported by others [2,[5][6][7]. Ninety percent of patients in this series suffered from previous anal symptoms especially haemorrhoidal prolapse.…”

Section: Discussionsupporting

confidence: 80%

Prospective randomised study of urgent haemorrhoidectomy compared with non‐operative treatment in the management of prolapsed thrombosed internal haemorrhoids

Allan¹,

Samad²,

Mellon

et al. 2005

Colorectal Disease

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Section: Discussionsupporting

confidence: 80%

Prospective randomised study of urgent haemorrhoidectomy compared with non‐operative treatment in the management of prolapsed thrombosed internal haemorrhoids

Allan¹,

Samad²,

Mellon

et al. 2005

Colorectal Disease

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“…After we adjusted for the other independent risk factors, the relative risk attributable to anemia increased to 6.79 (95% CI, 0.74-62. 22), but it did not reach statistical significance.…”

Section: Complicationsmentioning

confidence: 89%

Stapled Hemorrhoidectomy versus Conventional Excision Hemorrhoidectomy for Acute Hemorrhoidal Crisis

Lai

Jao

et al. 2007

Journal of Gastrointestinal Surgery

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We compared the safety and clinical outcomes of stapled hemorrhoidectomy and conventional excision hemorrhoidectomy in the treatment of acute hemorrhoidal crisis, and analyzed various factors associated with complications in stapled hemorrhoidectomy. Forty patients underwent stapled hemorrhoidectomy and forty underwent conventional excision hemorrhoidectomy. All had the operation under local anesthesia with conscious sedation within 24 h of admission. The length of surgery, hospital stay, disability, postoperative pain, and the use of analgesics were significantly less for patients in the stapled hemorrhoidectomy group. Stapled hemorrhoidectomy did not significantly increase the rate of complications. Five patients in the stapled group (12.5%) required further surgical intervention: three with thrombosed hemorrhoids and two with recurrent prolapse. No serious complications were reported in either group. Patient satisfaction was similar in the two groups. Increased age was identified as a factor that significantly elevated the risk of complications in the stapled group (OR, 1.06; 95% CI, 1.01-1.13). Anemia and time between the onset of prolapsed hemorrhoids and hospital admission were also risk factors for complications, although they were not significant. Stapled hemorrhoidectomy is a feasible treatment for selected patients with an acute hemorrhoidal crisis and has a similar complication rate to that of conventional excision hemorrhoidectomy. Stapled hemorrhoidectomy is superior in less-postoperative pain, shorter operation time, shorter hospital stay, and earlier return to normal activity. However, we suggest that older patients with anemia or a prolonged hemorrhoidal crisis are unsuitable for stapled hemorrhoidectomy.

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“…Numerous studies since have recommended otherwise [10][11][12][13][14][15] and fears of systemic infection appear unfounded. 16,17 Identifying the anatomy and leaving adequate mucocutaneous bridges can cause technical difficulties when operating on strangulated haemorrhoids.…”

Section: Operative Treatmentmentioning

confidence: 99%

“…12,13,18,19,21,22 None of these found the septic complications feared as a result of operating in the acute setting. Mazier describes 400 patients who underwent an 'emergency haemorrhoidectomy' although only 137 patients were known to have symptoms of less than 4 days' duration and only half had pain, calling into question his definition of 'acute disease'.…”

Section: Haemorrhoidectomymentioning

confidence: 99%

The acute management of haemorrhoids

Hardy

Cohen

2014

annals

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INTRODUCTION Although the acute thrombosis and strangulation of haemorrhoids is a common condition, there is no consensus as to its most effective treatment. METHODS A PubMed search was undertaken for papers describing the aetiology and treatment of the acute complications of haemorrhoids. RESULTS The anatomy and treatments for strangulated internal haemorrhoids and thrombosed perianal varices are discussed. Studies of the effectiveness and complications of conservative and operative treatments are reviewed. CONCLUSIONS Ambiguities exist in the terminology used to describe the two separate pathologies that make up the acute complications of haemorrhoids. These complications have traditionally been treated conservatively. There is evidence that early operative intervention for strangulated internal haemorrhoids is safe and effective. A suggested algorithm for treatment is given, based on the published literature.

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Immediate Hæmorrhoidectomy for Prolapsed Piles

Cited by 33 publications

References 0 publications

Prospective randomised study of urgent haemorrhoidectomy compared with non‐operative treatment in the management of prolapsed thrombosed internal haemorrhoids

Prospective randomised study of urgent haemorrhoidectomy compared with non‐operative treatment in the management of prolapsed thrombosed internal haemorrhoids

Stapled Hemorrhoidectomy versus Conventional Excision Hemorrhoidectomy for Acute Hemorrhoidal Crisis

The acute management of haemorrhoids

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