Timing and Modality of Hemorrhoidal Prolapse Impact on Patients' Quality of Life.

: The aim of this study was to assess whether the frequency and presentation modality of hemorrhoidal prolapse may have an impact on patients' quality of life, leading to a different categorization of patients. : A consecutive series of patients affected by primary hemorrhoidal disease were administered specific questionnaires to assess the severity of symptoms and their quality of life. The frequency/modality of prolapse was also assessed, and the classification of the patients into five categories was hypothesized.

Would Surgeons Like to Be Submitted to Anal Fistulotomy? An International Web-Based Survey.

Traditional fistulotomy is the most performed surgical procedure in anal fistula surgery. We conducted an international online survey to explore colorectal surgeons' opinions and preferences on fistulotomy. Considering the healing and continence impairment rates reported in the literature, surgeons were invited to answer as a hypothetic patient susceptible to being submitted to fistulotomy for low and high anal fistula.

Tunneling of Mesh during Ventral Rectopexy: Technical Aspects and Long-Term Functional Results.

Avoiding the extensive damage of pelvic structures during ventral rectopexy could minimize secondary disfunctions. The objective of our observational study is to assess the safety and functional efficacy of a modified ventral rectopexy. In the modified ventral rectopexy, a retroperitoneal tunnel was created along the right side of rectum, connecting two peritoneal mini-incisions at the Douglas pouch and sacral promontory.

The Emborrhoid Technique for Treatment of Bleeding Hemorrhoids in Patients with High Surgical Risk.

The Emborrhoid is an innovative non-surgical technique for the treatment of severe hemorrhoidal bleeding. Patient selection and the impact on quality of life have not been fully investigated. This prospective observational study aims to evaluate the clinical outcomes after Emborrhoid in patients with high surgical risk.

The pathogenesis of cryptoglandular anal fistula: New insight into the immunological profile.

Aim: The aetiology of cryptoglandular anal fistula (AF) is poorly understood. Evidence suggests that persistence and/or recurrence of the disease is more related to inflammatory than infectious factors. The aim of this study was to investigate the immune profile of cryptoglandular AF and to perform a histopathological characterization.

Human Amniotic Membrane for the Treatment of Cryptoglandular Anal Fistulas.

Background: Implantation of the amniotic membrane and their derivatives can have a beneficial effect on tissue repair and regeneration. We report for the first time the implant of an amniotic membrane in a patient affected by cryptoglandular anal fistula.

Methods: A patch of human amniotic membrane was implanted in a female patient affected by an anterior transphincteric fistula.

Outpatient Transradial Emborrhoid Technique: A Pilot Study.

Purpose: To determine whether outpatient transradial emborrhoid technique can be performed safely and effectively in the treatment of symptomatic hemorrhoids.

Materials And Methods: The transradial emborrhoid technique was used to treat 12 patients with symptomatic hemorrhoids in an outpatient setting during a 4-month period. After percutaneous catheterization of the left radial artery, a 5-Fr sheath was introduced to catheterize the inferior mesenteric artery and a microcatheter was advanced into the branches of the superior rectal artery for embolization with 0.

A Prospective Study on the Efficacy of Two Different Phlebotonic Therapies as a Bridge to Surgery in Patients with Advanced Hemorrhoidal Disease.

The aims of this study were to evaluate the efficacy of two different phlebotonic therapies, preoperatively administered in advanced hemorrhoidal disease (HD) patients with recommendation for surgery, and to assess patient satisfaction after treatment. In this prospective observational study, 100 patients were preoperatively treated either with micronized purified flavonoid fraction (group A) or sublingual nano-emulsion flavonoid (group B). HD symptoms, local inflammation signs and patients' satisfaction were evaluated at baseline visit (T0), after 4 weeks of therapy (T1) and 8 weeks after its discontinuation (T2).

Implant of Self-Expandable Artificial Anal Sphincter in Patients With Fecal Incontinence Improves External Anal Sphincter Contractility.

Background: External anal sphincter contractility significantly contributes to control the passage of stool. An artificial anal sphincter placed into the intersphincteric space is a safe and effective procedure to treat fecal incontinence, even if its mechanism of action has not been fully elucidated.

Objective: The aim of this study was to evaluate external anal sphincter contractility changes after a self-expandable hyexpan prostheses was implanted into the intersphincteric space of the anal canal and clinical outcomes compared.

One-year evaluation of anorectal functionality and quality of life in patients affected by mid-to-low rectal cancer treated with transanal total mesorectal excision.

Surgery of mid-to-low rectal cancer is still considered challenging. Transanal total mesorectal excision has been proposed to facilitate the mesorectal dissection, gain sphincter-saving procedures, and reduce functional sequelae. Few studies have investigated long-term functional outcomes and patients' quality of life.

Impact of COVID-19 Quarantine on Advanced Hemorrhoidal Disease and the Role of Telemedicine in Patient Management.

The aims of this population study were to assess the lockdown impact on patients waiting for hemorrhoidal surgery, and the role of telemedicine in patient management. All patients on our waiting list for hemorrhoidal surgery were considered. Eligible patients were contacted by phone.

The Management of Hemorrhoidal Disease by Dearterialization and Mucopexy.

Several minimally invasive surgical procedures have been recently developed to treat hemorrhoids without any excision. About 25 years ago, a non-excisional procedure providing doppler- guided ligation of the hemorrhoidal arteries has been proposed - named "hemorrhoidal dearterialization". The original technique has been modified over the years, and indications were expanded.

Anorectal Function and Quality of Life in IBD Patients With A Perianal Complaint.

Anorectal function of inflammatory bowel disease (IBD) patients is still poorly understood, with contradictory results. This prospective observational study aimed to analyze the effect of perianal disease on anorectal function and quality of life in IBD patients. Patient assessment included full clinical examination, validated scores, anorectal manometry, three-dimensional endoanal ultrasonography, and endoscopy.

Gatekeeper Improves Voluntary Contractility in Patients With Fecal Incontinence.

Background: Gatekeeper (GK) has shown to be safe and effective in patients with fecal incontinence (FI). We aimed to understand its mechanism of action by comparing pre- and post-implant change in the external anal sphincter (EAS) contractility.

Methods: Study of EAS contractility was conducted in 16 FI females (median age = 69 years) before and after implant of 6 GK prostheses.

Correction to: Transanal hemorrhoidal dearterialization (THD) for hemorrhoidal disease: a single-center study on 1000 consecutive cases and a review of the literature.

The article "Transanal hemorrhoidal dearterialization (THD) for hemorrhoidal disease: a single-center study on 1000 consecutive cases and a review of the literature" written by C. Ratto et al. was originally published Online First without open access.

Transanal hemorrhoidal dearterialization (THD) for hemorrhoidal disease: a single-center study on 1000 consecutive cases and a review of the literature.

Background: The transanal hemorrhoidal dearterialization (THD) Doppler procedure is a minimally invasive technique to treat symptomatic hemorrhoids. The aim of the study was to assess the clinical efficacy and the satisfaction of patients in a large series treated with THD and to review the relevant literature.

Methods: In this retrospective, single-institution, study consecutive patients with grade 2, 3, or 4 hemorrhoidal disease were treated with the THD Doppler procedure.

Prospective evaluation of a new device for the treatment of anal fistulas.

Aim: To evaluate the safety of the implantation of a new device for the treatment of anal fistulas. The short-term clinical efficacy was also assessed.

Methods: This study took place at a tertiary care university hospital.

Fistulotomy with end-to-end primary sphincteroplasty for anal fistula: results from a prospective study.

Background: Fistulotomy plus primary sphincteroplasty for complex anal fistulas is regarded with scepticism, mainly because of the risk of postoperative incontinence.

Objectives: The aim of this study was to evaluate safety and effectiveness of this technique in medium-term follow up and to identify potential predictive factors of success and postoperative continence impairment.

Design And Setting: This was a prospective observational study conducted at a tertiary care university hospital in Italy.

Dynamic transperineal ultrasound in the workup of men with obstructed defecation: a pilot study.

Background: Dynamic transperineal ultrasound has been used in women for the noninvasive investigation of functional disorders of the posterior pelvic floor, but its use in men has been limited by technical difficulties related to the consistency of the male perineum.

Objectives: The aim of this study was to explore the efficacy of dynamic transperineal ultrasound in diagnosing posterior pelvic floor dysfunction in men.

Design: This is a study of diagnostic accuracy.

Evaluation of transanal hemorrhoidal dearterialization as a minimally invasive therapeutic approach to hemorrhoids.

Purpose: Transanal hemorrhoidal dearterialization is an innovative technique to treat hemorrhoids using a specially designed proctoscope for Doppler-guided transanal ligation of hemorrhoidal arteries. We analyzed results of experience at a single-institution with this transanal hemorrhoidal dearterialization device.

Methods: Overall, 170 patients were submitted to transanal hemorrhoidal dearterialization during the period July 2005 through October 2008.

Sacral nerve stimulation is a valid approach in fecal incontinence due to sphincter lesions when compared to sphincter repair.

Purpose: Anal sphincter lesions represent the major cause of fecal incontinence, particularly in women. Sphincteroplasty with overlap is the traditional treatment, but a significant reduction in benefits within 5 years of surgery has been reported. More recently, sacral nerve stimulation has been suggested following sphincteroplasty or as primary treatment.