scholarly journals Delorme like Transanal Haemorrhoidal Dearterialization for the Treatment of Haemorrhoidal Disease

2016 ◽  
pp. 1-12
Author(s):  
Annibale Donini ◽  
Emanuel Cavazzoni ◽  
Emanuele Rosati ◽  
Luigina Graziosi ◽  
Elisabetta Marino
Keyword(s):  
Haemorrhoidal Disease ◽  
Transanal Haemorrhoidal Dearterialization

scholarly journals TRANSANAL HAEMORRHOIDAL DEARTERIALIZATION WITH MUCOPEXY (THD-M) FOR TREATMENT OF HEMORRHOIDS: IS IT APPLICABLE IN ALL GRADES? BRAZILIAN MULTICENTER STUDY

2020 ◽  
Vol 33 (2) ◽  
Author(s):  
Carlos Walter SOBRADO ◽  
Sidney KLAJNER ◽  
José Américo Bacchi HORA ◽  
Anderson MELLO ◽  
Fabricio Marcondes Luciano da SILVA ◽  
...  
Keyword(s):  
Intraoperative Complications ◽  
Late Results ◽  
Anal Abscess ◽  
Faecal Impaction ◽  
Haemorrhoidal Disease ◽  
Skin Tag ◽  
Effective Option ◽  
Grade Ii ◽  
Transanal Haemorrhoidal Dearterialization

ABSTRACT Background: Transanal haemorrhoidal dearterialization with mucopexy (THD-M) is a valuable option for treating patients with haemorrhoidal disease. However, there is still controversy with regard to its efficacy for more advanced grades. Aim: To evaluate the effectiveness of THD-M technique for treating hemorrhoidal disease and to compare the immediate and late results in different grades. Method: Seven hundred and five consecutive patients with Goligher’s grade II, III or IV symptomatic haemorrhoids underwent surgical treatment using the THD-M method in five participating centres. Six well-trained and experienced surgeons operated on the patients. Average follow-up was 21 months (12-48). Results: Intraoperative complications were observed in 1.1% of cases, including four cases of haematoma, two of laceration of the mucosa, and two of bleeding. All of these were controlled by means of haemostatic suturing. In relation to postoperative complications, the most common of these were as follows: transitory tenesmus (21.4%); pain (7.2%); mucosal or haemorrhoidal prolapse (6.4%); residual skin tag (5.6%); faecal impaction (3.2%); haemorrhoidal thrombosis (2.8%); bleeding (2.1%); anal fissure (0.7%); and anal abscess (0.3%). Most of the complications were treated conservatively, and only 7.5% (53/705) required some type of surgical approach. There was no mortality or any severe complications. The recurrence of prolapse and bleeding was greater in patients with grade IV haemorrhoidal disease than in those with grade III and II (26.54% and 7.96% vs. 2.31% and 0.92% vs. 2.5% and 1.25%), respectively. Conclusion: The THD-M method is safe and effective for haemorrhoidal disease grades II and III with low rates of surgical complications. However, for grade IV hemorrhoids, it is associated with higher recurrence of prolapse and bleeding. So, THD-M method should not be considered as an effective option for the treatment of grade IV hemorrhoids.

Classifications and Clinical Assessment of Haemorrhoids:The Proctologist’s Corner

2020 ◽  
Vol 15 ◽  
Author(s):  
Arcangelo Picciariello ◽  
Petr Tsarkov ◽  
Vincenzo Papagni ◽  
Sergey Efetov ◽  
Daniel Markaryan ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Clinical Evaluation ◽  
Clinical Assessment ◽  
Adult Population ◽  
Preoperative Assessment ◽  
Classification Systems ◽  
Patient Treatment ◽  
Benign Condition ◽  
Haemorrhoidal Disease ◽  
Therapeutic Choice

BACKGROUND: Haemorrhoidal disease (HD) is a benign condition affecting a considerable part of adult population. HD can be considered a social and economic burden with high impact on patient lifestyle. Several new techniques and devices have been proposed for HD treatment; however, preoperative assessment is essential and the use of classification system is recommended. METHODS: In the last two decades many studies described the preoperative assessment and several attempts of classification for HD. This review focuses on the most relevant studies found in literature where classification systems and clinical evaluation with differential diagnosis have been evaluated. RESULTS: The knowledge of classification systems and differential diagnosis for HD has been shown to play a central role in the clinical assessment and in the best treatment choice. Although there are new challenging techniques and devices for HD treatment, a preoperative assessment is always mandatory. CONCLUSION: Preoperative clinical evaluation is essential for HD patient treatment and outcome. Classification systems are useful for the therapeutic choice and for researches on new medical or surgical treatments. In fact, the international guidelines advise several therapeutic options depending on the severity of the HD.

Anatomy, Physiology and Pathophysiology of Haemorrhoids

2020 ◽  
Vol 15 ◽  
Author(s):  
Francesco Pata ◽  
Alessandro Sgrò ◽  
Francesco Ferrara ◽  
Vincenzo Vigorita ◽  
Gaetano Gallo ◽  
...  
Keyword(s):  
Anal Canal ◽  
Dentate Line ◽  
Cochrane Library ◽  
Systematic Research ◽  
Literature Searching ◽  
Patient History ◽  
Haemorrhoidal Disease ◽  
Faecal Continence ◽  
Vascular Component ◽  
Key Events

Background: Haemorrhoidal disease (HD) is a frequent anal disorder and one of the most common findings identified at colorectal clinic. This article aims to provide an overview of the anatomy, physiology and pathophysiology of haemorrhoids and haemorrhoidal disease. Introduction: Internal haemorrhoids are vascular cushions located in the anal canal, above the dentate line and covered by columnar epithelium. They contribute to the faecal continence and to the sensitivity of the anal canal. The enlargement and/or sliding of haemorrhoidal tissue produce symptoms and complications, the so-called haemorrhoidal disease. Method: A systematic research was realized, looking at the best evidence in literature , searching PubMed, Embase, Cochrane library and most renowned text of colorectal surgery from January 1980 to January 2020. Result: Aetiology and pathophysiology of HD are still controversial, but multifactorial. Disruption of stromal scaffolding, enlargement of vascular component, elevated anal pressure and rectal redundancy represent key events in the development and complications of the disease. Local inflammation may play also a role. Goligher’s classification remains the most widely used. A careful patient history and examination are paramount to diagnose HD, excluding other anal or colonic pathologies. Conclusion: Several aspects of etiopathogenesis and pathophysiology remain controversial. Further studies are needed to obtain a better understanding of the disease.

Scoring System for Haemorrhoidal Disease

2020 ◽  
Vol 15 ◽  
Author(s):  
Francesco Maria Romano ◽  
Guido Sciaudone ◽  
Silvestro Canonico ◽  
Francesco Selvaggi ◽  
Gianluca Pellino
Keyword(s):  
General Population ◽  
Scoring System ◽  
Careful Consideration ◽  
Hemorrhoidal Disease ◽  
Single System ◽  
Haemorrhoidal Disease ◽  
Definition Of

: Hemorrhoidal Disease (HD) is widely diffused throughout the general population. The system of classification currently used to categorize this pathology is that of Goligher (1975). This system only defines the morphology of the most represented hemorrhoid bearing. Several attempts in literature have been made to replace this system, but as of yet, no single system has been universally accepted. Some studies, however, have succeeded in identifying specific characteristics, besides morphology, that would be able to aptly define HD. An analysis of this literature, with careful consideration of the scores that have previously been proposed, is necessary in order to deepen and stimulate discussion about a possible new definition of HD.

Non-operative treatment for haemorrhoidal disease

2002 ◽  
Author(s):  
Mohamed A Thaha ◽  
Ken L Campbell ◽  
Robert JC Steele
Keyword(s):  
Operative Treatment ◽  
Haemorrhoidal Disease

scholarly journals Cost Effectiveness of Stapled Haemorrhoidopexy and Traditional Excisional Surgery for the Treatment of Haemorrhoidal Disease

2017 ◽  
Vol 2 (3) ◽  
pp. 271-280 ◽  
Author(s):  
Mary M. Kilonzo ◽  
Steven R. Brown ◽  
Hanne Bruhn ◽  
Jonathan A. Cook ◽  
Jemma Hudson ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Stapled Haemorrhoidopexy ◽  
Haemorrhoidal Disease ◽  
Excisional Surgery
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