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Medicina
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Special Conditions and Post-operative Complications in Haemorrhoidal Disease
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Special Conditions and Post-operative Complications in Haemorrhoidal Disease

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 24275

Special Issue Editors

Dr. Gaetano Gallo

E-Mail Website
Guest Editor
Department of Surgery, Sapienza University of Rome, Rome, Italy
Interests: surgery; surgical oncology; laparoscopic surgery; gastrointestinal diseases; functional bowel disorders; pelvic floor disorders; coloproctology
Special Issues, Collections and Topics in MDPI journals
Dr. Ugo Grossi

E-Mail Website
Guest Editor
IV Surgery Unit, Treviso Regional Hospital, University of Padua, 35122 Padua, Italy
Interests: liver transplantation; surgical oncology; cirrhosis; laparoscopic surgery; hepatocellular carcinoma; liver; liver surgery; gastrointestinal diseases
Special Issues, Collections and Topics in MDPI journals
Dr. Arcangelo Picciariello

E-Mail Website
Guest Editor
Department of Emergency and Organ Transplantation, University “Aldo Moro” of Bari, Piazza G Cesare, 11, 70124 Bari, Italy
Interests: surgical oncology; laparoscopic surgery; gastrointestinal surgery; colorectal surgery; general surgery; colorectal cancer; minimally invasive surgery; abdominal surgery; cancer surgery

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 2200 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

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Published Papers (2 papers)

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Review

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10 pages, 4180 KiB  
Review
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 - 1 Mar 2022
Cited by 7 | Viewed by 8934
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 [...] Read more.
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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13 pages, 492 KiB  
Systematic 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 23 | Viewed by 14532
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 [...] Read more.
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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