Internal hemorrhoid harboring adenocarcinoma: A case report

Caparelli, Michael L.; Batey, Jason; Tailor, Anisha; Braverman, Timothy; Barrat, Cory

doi:10.4251/wjgo.v13.i1.87

Cited by 4 publications

(2 citation statements)

References 9 publications

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“…Inclusion criteria were: (i) patients aged more than 18 years, (ii) hemorrhoids classified as degree II if bleeding, III, or IV if simple irreducible without ischemic changes, (iii) follow-up of at least 6 months (June 2022), (iv) failure to conservative or anal sparing treatments. Colonoscopy was performed to rule out inflammatory bowel disease, undiagnosed anal intraepithelial neoplasia, anal cancer, or other colorectal disease in patients with suspected symptoms or indications for screening (20,21). Exclusion criteria were: (i) fixed, fibrotic piles, degree IV hemorrhoids at advanced stage (irreducible hemorrhoids with ischemic changes and/or thrombosed), (ii) anorectal sepsis, (iii) hemorrhoids responsive to conservative treatments, (iv) previous anorectal surgery and/or anorectal cancer, (v) concomitant rectocele.…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Transanal hemorrhoidal dearterialization (THD) for hemorrhoidal disease: An Italian single-institution 5-year experience analysis and updated literature review

et al. 2022

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BackgroundHemorrhoidal disease is a highly prevalent, chronic disorder that usually compromise patients' quality of life. Despite recent advances in pharmacologic and surgical therapeutic options, a clear treatment “gold standard” is lacking. Our aim is to analyze the outcomes following Transanal Hemorrhoidal Dearterialization (THD) procedure.MethodsPatients who failed conservative treatment and underwent THD Doppler between 2017 and 2021 were enrolled. Follow-up interviews (consisting of clinical examination, Visual Analog Scale for pain—VAS, Vaizey incontinence score, Hemorrhoid Severity Score) were administered 1 week, 2 weeks, 1 month and 6 months after surgery.ResultsForty-seven out of 75 patients were male, and the mean age was 50 (± 17.9) years. Hemorrhoids were classified as Goligher's degree II in 25 cases, III in 40 and IV, simple irreducible without ischemic changes, in 10. The mean operative time was 35 (28–60) minutes, and most procedures were performed with epidural anesthesia (80%). No intraoperative complications occurred, and 73 patients (97.3%) were discharged within post-operative day 1. Early post-operative pain and bleeding occurred in 37.3% and 8% of patients, respectively. No patients experienced anal incontinence and severe symptoms at 6 months after surgery. The overall success rate was 97.3%.ConclusionsTHD is safe and effective in hemorrhoidal disease at degree II if bleeding, III, and IV without ischemic changes, both as a first intervention and on recurrence. Physician and patient need to understand each other's expectations, weight the risks and benefits, and customize the treatment.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%