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Article
Is co2 laser Hemorrhoidectomy superior to conventional open Hemorrhoidectomy?

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Abstract

Background: Hemorrhoids are one of the mostcommon surgical conditions .Conventionalhaemorrhoidectomy was the traditional operation forthe treatment of hemorrhoids. Other modalities oftreatment had been used as an alternative operationsincluding CO2 laser haemorrhoidectomy.Objectives: To determine the outcome of treatmentof hemorrhoids by using CO2 laserhaemorrhoidectomy and its advantages overconventional surgeryMethods: This is a retrospective comparativeinterventional study of 1024 case of third degreehaemorhoids selected out of 1300 case ofhemorrhoids of different degrees, admitted toALKINDY, ALYERMOUK teaching hospitals andABD ALMAGEED private hospital, from May 1998to July 2002,they were treated by CO2 laserhaemorrhoidectomy and conventional surgery. Theyare divided into 2 groups randomly, 512 cases treatedby CO2 laser (group A), 512 cases treated byconventional surgery (group B). Both groups werestudied regarding operative time, hospital stay,healing time, post operative complications and costeffectiveness.Results: In GROUP A, the operative time rangedfrom 10 to 20 minutes with an average of 13 minutes.The hospital stay ranged from 4 to 12 hours with amean time of 10 hours as all cases were treated asday cases. Post operative pain was minimal in 50% ofpatients and required simple analgesia for treatmentwhile 50% had no pain. Bleeding occurred in lessthan 1% of cases, anal stenosis 3.3%, Infectionrecorded in 0.58% of patients.In GROUP B, Theoperative time ranged from 15 to 25 minutes with anaverage time of (19) minutes, hospital stay rangedfrom 24 to 48 hours with a mean time of 28 hours.Post operative pain recorded in all the patients(100%) and required narcotic analgesia for treatment,25 patients (4.8%) had varying degrees of bleeding,40 patients (7.8%) had infection, 25 patients (4.8%)had anal stenosis.In group A due to shorter hospitalstay, earlier healing of wounds, earlier return to workwhich was within 7 to 10 days, the surgical treatmentproved to be cost effective.Conclusion: CO2 laser Hemorrhoidectomy wasfound to be easy and safe procedure with lower rateof complications, shorter hospital stay and costeffective.

Keywords

Co2 --- Laser --- Hemorrhoids


Article
LigaSure Hemorrhoidectomy versus Excisional Diathermy Hemorrhoidectomy for All Symptomatic Hemorrhoids

Author: Ibrahim Falih Noori
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2018 Volume: 15 Issue: 1 Pages: 83-88
Publisher: Babylon University جامعة بابل

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Abstract

Background: Hemorrhoidectomy by LigaSure electrosurgical unit seems to be very effective treatment and results in better surgicaloutcomes when compared with the conventional excisional hemorrhoidectomy. Objective: The aim of this study was to compare thefeasibility and the surgical outcomes of LigaSure hemorrhoidectomy with that of conventional diathermy excisional hemorrhoidectomy.Materials and Methods: Patients characteristics were comparable in both groups. Ninety six patients with symptomatic mainly grade III andIV piles were randomized for either conventional excisional hemorrhoidectomy (48 patients) or to LigaSure hemorrhoidectomy (48 patients)for the period from April 2014 to July 2016. The surgical outcomes of both procedures including the operative time, intra-operative bloodloss, postoperative pain, analgesic requirements, early and late postoperative complications, wound healing, recovery time and return towork, recurrence and patient satisfaction were recorded, compared and evaluated. Results: The mean operative time and amount of intraoperativeblood loss were significantly lower in LigaSure hemorrhoidectomy group. Postoperative pain and need for parentral analgesiawere comparable in the first 24 -48 hours postoperatively, but they were significantly lower in LigaSure group after the second postoperativeday. Faster wound healing and early return to work were obviously noted among patient subjected to LigaSure hemorrhoidectomy. Earlypostoperative complications were lower in LigaSure group while late complications were comparable in both groups. Lastly, LigaSure groupshowed high satisfaction rate compared to conventional hexcisional hemorrhoidectomy group. Conclusion: LigaSure hemorrhoidectomy issuperior and more advantageous in term of operative time, blood loss, post-operative complications, faster wound healing and return to work.It is simple, feasible and easy to learn.


Article
A PROSPECTIVE STUDY OF RUBBER BAND LIGATION OF HEMORRHOIDS IN SULAIMANY, KURDISTAN REGION, IRAQ
دراسة مستقبلية حول عقد البواسير بالحلقة المطاطية في محافظة السليمانية، العراق

Author: NIZAR MT. HAMAWANDI نزار حموندي
Journal: Duhok Medical Journal مجلة دهوك الطبية ISSN: ISSN: 20717334 (online)/ ISSN: 20717326 (Print) Year: 2010 Volume: 4 Issue: 2 Pages: 92-98
Publisher: University of Dohuk جامعة دهوك

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Abstract

Background and Objectives Hemorrhoids is a common disease. There are different lines of treatment of hemorrhoids. The objective of the study is to determine the effectiveness and the safety of rubber band ligation of hemorrhoids as an outpatient surgical clinic procedure.Methods A prospective study was done over a period of one year, from 1st July 2007 to 31st June 2008, during that period, 322 patients with symptomatic hemorrhoids were seen in a private outpatient surgical clinic. Out of those 322 patients, 108 patients were selected whom they had second and third degree hemorrhoids. Data were collected about their presenting symptoms, physical examination and proctoscopic appearance. They were treated with rubber band ligation, and were followed up for a period of one year. Out of those 108 patients, 9 patients failed to complete the follow up and they were excluded from the study. Outcome data were recorded from the remaining 99 patients and studied for success of the treatment and complications.Results Out of those 99 patients treated with RBL, 89 (89.89%) patients became free from symptoms and cured, 10 patients (10.1%) remained symptomatic and treated with conventional hemorrhoidectomy.Conclusion From this study it was found that the RBL of hemorrhoids performed as an outpatient surgical clinic procedure, is easy, convenient and successful procedure for treatment of 2nd and 3rd degree symptomatic hemorrhoids.

خلفبة و اهداف البحث: البواسير من الامراض الشائعة. هنالك عدة طرق لعلاج البواسير. هدف البحث هو تقدير كفائة و سلامة عقد البواسير بالحلقة المطاطية في العيادات الجراحية.طريق البحث: دراسة مستقبلية تمت على مدار سنتين من 1 تموز2007 الى 31 حزيران 2008 حيث شملت 331 مريضا شوهدوا في عيادة جراحية خاصة. من هؤلاء المرضى أختيرت 108 مريضا يعانون من البواسير من الدرجة الثانية و الثالثة. جمعت البيانات حول أعراض المرض، الفحص السريري، فحص الناضور الشرجي و درجة البواسير. المرضى عولجوا بطريقة عقد البواسير بالحلقة المطاطية مستخدما طريقة بارون، مع وضع حلقة مطاطية واحدة في كل زيارة. من هؤلأء المرضى، 9 منهم فقدوا أثنأء المتابعة و حذفوا من الدراسة. أخذت البيانات من بقية 99 مريضا وأجريت الدراسة عليهم لبيان نسبة النجاح و الأختلاطات.النتائج: 89 مرضى من مجموع 99 مرضى (89,89 %) عولجوا عن طريق العقد بالحلقة المطاطية كانوا بدون أعراض و قد اكتسبوا الشفاء. و 10 مرضى استمروا في الشكوى من اعراض المرض و تم أحالتهم الى العملية الجراحية.الاستنتاج: أظهرت نتائج الدراسة أن عقد البواسير بالحلقة المطاطية في العيادات الجراحية عملية سهلة، ملائمة و ناجحة لعلاج البواسير من الدرجة الثانية و الثالثة.


Article
A Comparative Study OF Three Lines Of Surgical Management Of Hemorrhoidal

Author: Ali Hussein Abid Suwailem
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2015 Volume: 8 Issue: 1 Pages: 2113-2117
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Disease is a common problem in surgical practice is hemorrhoidaldisease.Objective: to compare three different methods of treatment of second and uncomplicated third degree piles.Subject and Methods: This prospective study compares three different methods of treatment in 180 patients of second and uncomplicated third degree piles. The patients were allocated randomly in equal numbers to three groups: Group A- treated by conventional excision ligation Milligan Morgan, Group B-treated by pilesuture and Group C-treated by rubber band ligation.Results and Discussion: The average period of follow up after completion of treatment was 36 months. Patients were assessed for early complications; Pain-Urine Retention-and bleeding. Late complications;-anal stenosis, recurrence-Length of hospital stay and Time-off work. We consider that conservative treatment methods are preferable to conventional excision ligation for treatment of second and early third degree piles.Conclusion: Of the two conservative methods used in this study, the pile suture seems to be the method of choice.


Article
12.CO2 DIODE LASER HEMORRHOIDECTOMY: CLINICAL EXPERIENCE WITH 150 PATIENTS

Author: Ibrahim F. Noori ابراهيم فالح نوري
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2017 Volume: 15 Issue: 4 Pages: 411-419
Publisher: Al-Nahrain University جامعة النهرين

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Background: Hemorrhoids are the most common benign anorectal conditions. About half of population are affected by hemorrhoids during their life time. Conventional surgical hemorrhoidectomy, which was the standard treatment for many decades are associated with remarkable and intolerable pain that may last up to 3 to 6 weeks, which makes more patients reluctant to surgery. Laser hemorrhoidectomy is relatively new promising modality with less postoperative pain and less complications with fast wound healing and early return to work.Objective: To assess the validity, feasibility and the outcomes of using the CO2 diode laser for treatment of symptomatic hemorrhoids.Methods: A prospective study conducted for the period from September 2013 to April 2015, included 150 patients (135 male and 15 female), with symptomatic first, second and third degree piles with age ranged from 24 to 83 years (mean 48.7 year) submitted to CO2 diode laser hemorrhoidectomy with either the coagulation mode or cutting mode of 30 Watt diode laser surgical machine. The procedures were done under local anesthesia as a day case surgery by single surgeon. Results: The results showed that the operative time ranges from 15 to 30 minutes (mean 23.5 minutes). Postoperative pain scores by visual analog scale (VAS) in the first, second and third postoperative days were 2.9, 2.1, 1.8 respectively. The pain decreased rapidly after the first week and reached to zero after 14 days postoperatively. The complications rate recorded in this work was 7.3%. All these complications were mild and can be dealt with conservatively; redo surgery was not required in any case. All patients were discharged 2 to 4 hours postoperatively and were followed for 3 to 6 months.Conclusion: Hemorrhoidectomy by CO2 diode laser is effective, and very quick outpatient procedure with very mild postoperative pain and low or negligible rate of complications. It associated with rapid healing and fast recovery that most patient can return to normal daily activity within 2 to 5 days. These results are considered a big advantage upon conventional hemorrhoidectomy.Keywords: Hemorrhoids, laser hemorrhoidectomy, CO2 diode laserCitation: Noori IF. CO2 Diode Laser hemorrhoidectomy: clinical experience with 150 patients. Iraqi JMS. 2017; Vol. 15(4). 411-419. doi: 10.22578/IJMS.15.4.12


Article
Assessment of hemorrhoids and anal fissure occurrences in women during pregnancy in Pirmam City/Iraq
تقييم حدوث البواسير و الناسور الشرجى عند النساء أثناء الحمل في مدينة بيرمام/العراق

Authors: Pola Farhad Hassan --- Hamdia Mirkhan Ahmed Lecturer
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2015 Volume: 5 Issue: 2 Pages: 58-64
Publisher: University of Kufa جامعة الكوفة

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Abstract

Aim: The aim of this study was assessment of obstetrical characteristics of women with hemorrhoids and anal fissure. Methods: A cross-sectional study was conducted between 1st September 2013 and 30th July 2014 in Pirmam city in Kurdistan Region of Iraq on 50 women who attend surgical private clinic and complained with signs and symptoms of hemorrhoids and anal fissures and diagnosed by observation and physical examination of the anus. A questionnaire was constructed for the purpose of the study. Chi-square test or Fisher exact test were used for analyzing of the data. Results: Mean (M±SD) age of women were 30.36 (± 7.4). The rate of hemorrhoids, fissures or both were as following respectively: 14%, 48% and 38%. Sixty two percent of the study sample were multipara. The majority (84%) of the sample had vaginal delivery. There was statistically significant association between prolonged labor with aggravation of hemorrhoids and fissures by pregnancy/delivery but there was no statistically significant association between onset of hemorrhoids or fissures and their aggravation by pregnancy/delivery with parity and mode of delivery.Conclusions: Hemorrhoids and anal fissures were most common in multipara and grand multipara women and who delivered vaginally. These conditions may aggravated by pregnancy and delivery.Recommendation: Advising and educating women for appropriate diet and bowel motion during pregnancy and improving care during labor may decrease the hemorrhoids and anal fissures. Further studies with large sample size and case- control study will help to understand the effect of childbearing experience on anal disorders

الهدف: تهدف الدراسة الى اجراء عملية تقييم مواصفات التوليد للنساء المصابات بالبواسير و الناسور الشرجى.المنهجية: أجريت دراسة مقطعيه للفترة من1/9/2013 - 30/7/2014 في مدينة بيرمام في اقليم كوردستان/العراق. و قد شملت الدراسة 50 امرأه من المراجعات العيادة الجراحية الخاصة و اللواتى يعانين و اللذين كان يعانون من اعراض و علامات الاصابه بالبواسير و الناسور الشرجى. و قد تم تشخيصهم من خلال الفحص السريري مسبقا. وتم اعداد استماره استبيانية لهذا الغرض. و تم استخدام مربع كاي لتحليل النتائج .النتائج: اظهرت النتائج ان معدل المتوسط و(الانحراف المعيارى) لأعمار النساء هو 30.36 (±7.4). و كانت نسبة الأصابه بالبواسير(14%) و الناسور (48%) او كلاهما (38%). و أظهرت النتائج بأن 62% من النساء كانت متعددات الولادات. وكان نسبة (84%) منهم لديهم ولادة طبيعية. و كان هنالك دلالة احصائية بين طول فترة الولادة و شدة الصابة الأصابة بالبواسير و الناسور. واظهرت النتائج بأنه لم تكن هنالك علاقة ذات دلالة احصائية بين بداية الأصابة بالبواسير و الناسور و شدة مع عدد الولادات او طريقة الولادة.الاستنتاج: ان البواسير و الناسور الشرجى كانت أكثر شيوعاَ لدى النساء المتعددات الولادات والذين لديهم اكثر من خمسة ولادات و كذلك بين نساء ذات الولادة الطبيعية. التوصيات: اعطا النصيحه و التثقيف للامهات حول الغذاء المناسب و حركة الامعاء خلال حمل و تحسين الرعايه خلال الولادة والتى قد تقلل البواسير والناسور الشرجى. الحاجه الى دراسات اخرى و بعينة اكبر و اجراء دراسة من نوع الشاهد والحالة التي قد تساعد لمعرفة تأثير الحمل على إصابات الشرج.

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