Purpose: Hemorrhoidectomy is the treatment of choice for patients with third-degree or fourth-degree hemorrhoids. However, whether the closed or open technique yields better results is unknown. The purpose of this study was to compare these techniques with respect to operating time, analgesic requirement, hospital stay, morbidity rate, duration of inability to work, healing time, and follow-up results.
Methods: In this prospective and randomized study, 80 patients with third- degree or fourth-degree hemorrhoidal disease were allocated to either the open- hemorrhoidectomy (Group A, n = 40) or the closed-procedure group (Group B, n = 40). Open hemorrhoidectomy was performed according to the St. Mark's Hospital technique, whereas the Ferguson technique was used for the closed procedure under general anesthesia with the patient in the jackknife position.
Results: Mean operating time was significantly shorter in Group A (35 +/- 7 vs. 45 +/- 8 minutes, P < 0.001). Analgesic requirement on the day of surgery and the first postoperative day was also significantly lower (P < 0.05). The morbidity rate was higher in Group B (P < 0.05). Length of hospital stay and duration of inability to work were similar in both groups (P > 0.05). Healing time was significantly shorter in Group B (2.8 +/- 0.6 vs. 3.5 +/- 0.5 weeks, P < 0.001). Median follow-up time was 19.5 (range, 4-40) months. The only late complication (anal stenosis) was observed in one patient in Group B.
Conclusions: Although the healing time is longer, the open technique is more advantageous with respect to shorter operating time, less discomfort in the early postoperative period, and lower morbidity rate.
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http://dx.doi.org/10.1007/s10350-004-6116-1 | DOI Listing |
J Med Internet Res
January 2025
Department of Anesthesiology, Daping Hospital, Army Medical University, Chongqing, China.
Background: Recent research has revealed the potential value of machine learning (ML) models in improving prognostic prediction for patients with trauma. ML can enhance predictions and identify which factors contribute the most to posttraumatic mortality. However, no studies have explored the risk factors, complications, and risk prediction of preoperative and postoperative traumatic coagulopathy (PPTIC) in patients with trauma.
View Article and Find Full Text PDFJMIR Res Protoc
January 2025
Orthopedics and Trauma Surgery, University Hospital Düsseldorf, Düsseldorf, Germany.
Background: An aging population in combination with more gentle and less stressful surgical procedures leads to an increased number of operations on older patients. This collectively raises novel challenges due to higher age heavily impacting treatment. A major problem, emerging in up to 50% of cases, is perioperative delirium.
View Article and Find Full Text PDFJAMA Surg
January 2025
Department of Surgery, Rutgers Health, New Jersey Medical School, Newark.
Cardiovasc Interv Ther
January 2025
Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
Advances in chronic thromboembolic pulmonary hypertension (CTEPH) treatment have improved prognosis, shifting focus towards symptom management. This study aimed to identify factors influencing the World Health Organization functional class (WHO-FC) in CTEPH patients. The CTEPH AC registry is a prospective, multicenter database from 35 Japanese institutions, analyzing data from August 2018 to July 2023.
View Article and Find Full Text PDFSpine Deform
January 2025
Great North Children's Hospital, Newcastle Upon Tyne, UK.
Purpose: To determine the prevalence of scoliosis in patients who have undergone surgical repair of CDH and attempt to assess the aetiology of scoliosis in affected cases.
Methods: A prospectively collected database of patients with CDH treated in a single centre between 1997 and 2023 was reviewed. Cases with adequate records who continued to reside locally having survived beyond age 2 and > 2 years following CDH repair were included.
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