Online ISSN: 2515-8260

Keywords : Hemorrhoidectomy


CLINICO-PATHOLOGICAL STUDY OF ANAL CANAL DISEASES AT TERTIARY CARE HOSPITAL IN WESTERN RAJASTHAN

Dr.Kuldeep Kumar, Dr. Ashok Kumar, Dr. Vaishali, Dr. Ghanshyam Gahlot

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 3372-3384

Introduction: Anal canal diseases include different pathologic disorders that generate significant patient discomfort and disability. Although these are frequently encountered in general medical practice, they often receive only casual attention and temporary relief. 
Aim and Objective: This study was intended for a clinico-pathological analysis of different conditions with Clinical presentation and their clinical diagnostic and treatment modalities based on various demographic features and associated conditions.
Material and methods: The data were collected from under study population through a pretested and semi-structured schedule, which was designed in such a manner that more information regarding demographic profile, risk factors, morbidity and diagnosis could be collected.100 patients aged between 21to>50 were selected who were diagnosed as various Anal canal diseases in admitted and underwent surgical interventions during Nov 2020 to Oct 2021.
Results: Data related to objectives of the study were collected and analysed. Patients belonging to the age group 31-40 constituted the majority (33%). There was male predominance with (75%) male and (25%) female. According to related co-morbidities most of cases had Constipation (94%). hemorrhoids were the most common incidence of diagnosis 50%, anal fistula (18%), anal fissure (13%), Abscess (8%), anal polyp (2%) and patients have anal neoplastic (5%) condition which all were malignant and other various conditions. Most Anal canal diseases were revealed to type of management, majority of patients (41%) had hemorrhoidectomy, followed by (15%) patients had fistulectomy, (8%) had I&D, (6%) each had fistulectomy with hemorrhoids ligation and Lord's dilatation with hemorrhoids ligation, (2%) patients each had excision of polyp and Lord's stitching. 3% patients each had abdominoperineal resection and lateral sphincterotomy. (4%) patients each had lord's dilation with excision of sentinel tags and conservative management.
Conclusion: Anal canal disorders include a diverse group of pathologic conditions like hemorrhoids, anal fissure, fistula, perianal Abscess etc. Although non-operative management is often the initial treatment, surgical option always needs to be a component of the armamentarium for dealing with these diverse processes. Thus, surgeons need to be aware of the aspects of approaching the patient with anal pathology, as ultimate recovery and function depend on accurate and proper evaluation and management.

Maximum sutureless closed haemorrhoidectomy for symptomatic haemorrhoids grades III and IV: An observational cross-sectional study in Eastern Indian population

Mohamed Ashraf Ali, Mohammad Nehal Ahmad, Md. Zahid Hussain, Md Mazharul Haque

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 259-265

Introduction: Haemorrhoids are dilated vascular structures that act as a cushion around the
anal canal. Haemorrhoidectomy is the gold standard surgical protocol for symptomatic
haemorrhoids in grades III and IV. The incidence rate of symptomatic haemorrhoids ranges
from 4.4 to 36.4% of the general population. There are many aetiological factors that can
cause haemorrhoidal disease, which include: constipation, pregnancy, increased intraabdominal
pressure with obstruction of venous return, diarrhoea, prolonged straining, aging,
and abnormalities of internal and sphincter. With the arrival of newer devices,
hemorrhoidectomy resulted in less postoperative pain and less perioperative blood loss
compared with haemorrhoidectomies done with conventional surgical techniques. Maximum
(KLS Martin Group, Germany) is the new launch in vessel sealing systems that has been
introduced recently. It is a bipolar electrosurgical device that is a combination of pressure and
radiofrequency. It seals the blood vessels with a diameter of up to 6 mm by denaturing elastin
and collagen from the vessel wall and connective tissue around them with minimal damage to
the collateral structures limited to 2 mm over the surgical site. This coagulation zone can
withstand up to 3 times the systolic blood pressure