Navegando por Palavras-chave "Hemorrhoids"
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- ItemAcesso aberto (Open Access)Efeito da nifedipina gel 0,2% nas pressões de canal anal e na dor pós-operatória: estudo após hemorroidectomia pela técnica aberta(Cidade Editora Científica Ltda, 2007-12-01) Cesar, Maria Auxiliadora Prolungatti; Klug, Wilmar Artur; Bassi, Deomir Germano [UNIFESP]; Paula, Pedro Roberto De [UNIFESP]; Cesar, Rosana Prolungatti; Ortiz, Jorge Alberto; Speranzini, Manilio Basilio; FCMSCSP; Universidade de Taubaté; Universidade Federal de São Paulo (UNIFESP); Hospital Universitário de Taubaté Serviço de Endoscopia e Motilidade Digestiva; Faculdade de Ciências Médicas da Santa Casa de São Paulo; Universidade de São Paulo (USP); Faculdade de Medicina do ABCINTRODUCTION: Hemorrhoids are very common and pain following their surgical treatment causes great suffering. Various alternatives have been studied for reducing postoperative pain. Among these is surgical sphincterotomy, which may in some cases cause some degree of fecal incontinence. For this reason, several studies have used chemical sphincterotomy, with nifedipine, diltiazem, glycerin trinitrate or botulinum toxin. The objective of the present study was to investigate the effects of topical nifedipine for reducing anal canal pressures and consequently reducing postoperative pain. MATERIAL AND METHOD: Topical gels of 0.2% nifedipine plus 2% lidocaine (Group 1) and 2% lidocaine alone (Group 2) were used following hemorrhoidectomy. Pressures were measured before the operation and on the first, fourth and seventh days after the operation. Pain was also evaluated on all of the first seven postoperative days using a visual analog scale. RESULTS: There were no differences in relation to anal canal pressures, but lower pain levels were reported in the group that received nifedipine. CONCLUSION: Nifedipine gel was efficient for postoperative analgesia, but did not alter anal canal pressures.
- ItemAcesso aberto (Open Access)Hemorrhoids: an experimental model in monkeys(Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2006-10-01) Plapler, Helio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: Hemorrhoids are a matter of concern due to a painful outcome. We describe a simple, easy and reliable experimental model to produce hemorrhoids in monkeys. METHODS: 14 monkeys (Cebus apella) were used. After general anesthesia, hemorrhoids were induced by ligation of the inferior hemorrhoidal vein, which is very alike to humans. The vein was located through a perianal incision, dissected and ligated with a 3-0 vicryl. The skin was sutured with a 4-0 catgut thread. Animals were kept in appropriate cages and evaluated daily. RESULTS: Nine days later there were hemorrhoidal piles in the anus in fifty percent (50%) of the animals. Outcome was unremarkable. There was no bleeding and all animals showed no signs of pain or suffering. CONCLUSION: This is an affordable and reliable experimental model to induce hemorrhoids for experimental studies.
- ItemAcesso aberto (Open Access)Rubber band ligation and infrared photocoagulation for the outpatient treatment of hemorrhoidal disease(Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2008-02-01) Ricci, Maurício Pichler [UNIFESP]; Matos, Delcio [UNIFESP]; Saad, Sarhan Sydney [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To compare the results of rubber band ligation and infrared photocoagulation for the treatment of hemorrhoidal disease through the analysis of the incidence of complications after each treatment and respective success rate. METHODS: Forty-eight patients with first, second or third degree hemorrhoidal disease were randomized to recieve treatment with either rubber band ligation (n=23) or infrared photocoagulation (n=25). Each patient was assessed at 1 week and 4 week intervals after treatment. We compared the incidence of complications and efficiency of each treatment modality and Qui-square, Fisher's Exact Test and Student's t Test were used to statistical analysis. RESULTS: Bleeding occured in eigth (34,7%) patients treated with rubber band ligation and in four (16,0%) after infrared photocoagulation (p=0,243). Thirteen (52,0%) patients felt pain during infrared photocoagulation and 9 (39,1%) after rubber band ligation (p=0,546). After rubber band ligation, 14 (60,8%) required medication for pain relief. One patient (4,0%) required medication after infrared photocoagulation (p<0,001). Three (13,0%) patients treated with rubber band ligator and 1 (4,0%) treated with infrared photocoagulation had symptomatic mucosal ulcers. Perianal dermatitis occured in two (8,0%) patients treated with infrared photocoagulation and one patient (4,3%) was observed to have prolapsed thrombosed piles after rubber band ligation. One month after treatment, 17 of 23 patients treated with rubber band ligation (73,9%) and 18 of 25 patients treated with infrared photocoagulation were asymptomatic. Rubber band ligation treated bleeding and prolapse in 90,0% and 82,4% respectively. Infrared photocoagulation treates bleeding and prolapse in 93,7% and 87,5% respectively. Those differences are not significant. CONCLUSION: Rubber band ligation causes significantly more pain than infrared photocoagulation during the first week after the procedures and their success rate are not different after four weeks of treatment.