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Special Conditions and Post-operative Complications in Haemorrhoidal Disease

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A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Surgery".

Deadline for manuscript submissions: closed (30 April 2022) | Viewed by 18021

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Special Issue Information

Dear Colleagues,

Haemorrhoidal Disease (HD) is the fourth leading outpatient digestive system diagnosis in the United States.

Although HD is one of the oldest and most studied diseases, there are some special conditions that are rare and difficult to manage. For example, the prevalence of HD is higher in pregnancy than in non-pregnant women, but insufficient data exist on the safety of anti-haemorrhoidal treatment in pregnancy. The latter dilemma is also reflected in the treatment of other conditions associated with HD such as inflammatory bowel disease, coagulopathies or elderly patients.

Furthermore, non-excisional or excisional surgical treatment for II–IV degree HD can often provoke several complications that deeply modify the patient's quality of life.

The purpose of this Special Issue is to demonstrate the state of the art regarding some of the rare conditions and post-operative complications related to HD.

In this Special Issue, we are encouraging experienced colleagues to submit original research articles, case studies, and review articles regarding special conditions and post-operative complications in HD.

Dr. Gaetano Gallo
Dr. Ugo Grossi
Dr. Arcangelo Picciariello
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

pregnancy
thrombosed hemorrhoidal disease
coagulopathies
immunosuppressed patients
elderly
inflammatory bowel disease
radiation proctitis
post-operative pain
bleeding
anal stenosis
reoperation

Published Papers (2 papers)

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Review

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10 pages, 4180 KiB

Open AccessReview

New Techniques in Hemorrhoidal Disease but the Same Old Problem: Anal Stenosis

by Sezai Leventoglu, Bulent Mentes, Bengi Balci and Halil Can Kebiz

Medicina 2022, 58(3), 362; https://doi.org/10.3390/medicina58030362 - 01 Mar 2022

Cited by 7 | Viewed by 6816

Abstract

Anal stenosis, which develops as a result of aggressive excisional hemorrhoidectomy, especially with the stoutly use of advanced technologies (LigaSure^®, ultrasonic dissector, laser, etc.), has become common, causing significant deterioration in the patient’s quality of life. Although non-surgical treatment is effective for mild anal stenosis, surgical reconstruction is unavoidable for moderate to severe anal stenosis that causes distressing, severe anal pain, and inability to defecate. The problem in anal stenosis, unlike anal fissure, is that the skin does not stretch as a result of chronic fibrosis due to surgery. Therefore, the application of lateral internal sphincterotomy does not provide satisfactory results in the treatment of anal stenosis. Surgical treatment methods are based on the use of flaps of different shapes and sizes to reconstruct the anal caliber and flexibility. This article aims to summarize most-used surgical techniques for anal stenosis regarding functional and surgical outcomes. Full article

(This article belongs to the Special Issue Special Conditions and Post-operative Complications in Haemorrhoidal Disease)

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Other

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13 pages, 492 KiB

Open AccessSystematic Review

Strategies to Reduce Post-Hemorrhoidectomy Pain: A Systematic Review

by Varut Lohsiriwat and Romyen Jitmungngan

Medicina 2022, 58(3), 418; https://doi.org/10.3390/medicina58030418 - 12 Mar 2022

Cited by 13 | Viewed by 10510

Abstract

Background and Objectives: Excisional hemorrhoidectomy is considered as a mainstay operation for high-grade hemorrhoids and complicated hemorrhoids. However, postoperative pain remains a challenging problem after hemorrhoidectomy. This systematic review aims to identify pharmacological and non-pharmacological interventions for reducing post-hemorrhoidectomy pain. Materials and Methods: The databases of Ovid MEDLINE, PubMed and EMBASE were systematically searched for randomized controlled trails (published in English language with full-text from 1981 to 30 September 2021) to include comparative studies examining post-hemorrhoidectomy pain as their primary outcomes between an intervention and another intervention (or a sham or placebo). Results: Some 157 studies were included in this review with additional information from 15 meta-analyses. Fundamentally, strategies to reduce post-hemorrhoidectomy pain were categorized into four groups: anesthetic methods, surgical techniques, intraoperative adjuncts, and postoperative interventions. In brief, local anesthesia-alone or combined with intravenous sedation was the most effective anesthetic method for excisional hemorrhoidectomy. Regarding surgical techniques, closed (Ferguson) hemorrhoidectomy performed with a vascular sealing device or an ultrasonic scalpel was recommended. Lateral internal anal sphincterotomy may be performed as a surgical adjunct to reduce post-hemorrhoidectomy pain, although it increased risks of anal incontinence. Chemical sphincterotomy (botulinum toxin, topical calcium channel blockers, and topical glyceryl trinitrate) was also efficacious in reducing postoperative pain. So were other topical agents such as anesthetic cream, 10% metronidazole ointment, and 10% sucralfate ointment. Postoperative administration of oral metronidazole, flavonoids, and laxatives was associated with a significant reduction in post-hemorrhoidectomy pain. Conclusions: This systematic review comprehensively covers evidence-based strategies to reduce pain after excisional hemorrhoidectomy. Areas for future research on this topic are also addressed at the end of this article. Full article

(This article belongs to the Special Issue Special Conditions and Post-operative Complications in Haemorrhoidal Disease)

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