AIM: To evaluate the methodology, feasibility, safety and efficacy of a novel method called cap-assisted endoscopic sclerotherapy(CAES) for internal hemorrhoids.METHODS: A pilot study on CAES for grade Ⅰ to Ⅲ intern...AIM: To evaluate the methodology, feasibility, safety and efficacy of a novel method called cap-assisted endoscopic sclerotherapy(CAES) for internal hemorrhoids.METHODS: A pilot study on CAES for grade Ⅰ to Ⅲ internal hemorrhoids was performed. Colon and terminal ileum examination by colonoscopy was performed for all patients before starting CAES. Polypectomy and excision of anal papilla fibroma were performed if polyps or anal papilla fibroma were found and assessed to be suitable for resection under endoscopy. CAES was performed based on the requirement of the cap, endoscope, disposable endoscopic long injection needle, enough insufflated air and sclerosing agent.RESULTS: A total of 30 patients with grade Ⅰ to Ⅲ internal hemorrhoids was included. The follow-up was more than four weeks. No bleeding was observed after CAES. One(3.33%) patient claimed mild tenesmus within four days after CAES in that an endoscopist performed this procedure for the first time. One hundred percent of patients were satisfied with this novel procedure, especially for those patients who underwent CAES in conjunction with polypectomy or excision of anal papilla fibroma.CONCLUSION: CAES as a novel endoscopic sclerotherapy should be a convenient, safe and effective flexible endoscopic therapy for internal hemorrhoids.展开更多
Objective:Hemorrhoidal disease(HD)is the most common proctological disease,with an estimated prevalence rate of 4.4%,and a peak in individuals between 45 and 65 years of age.This study was done to evaluate whether Lia...Objective:Hemorrhoidal disease(HD)is the most common proctological disease,with an estimated prevalence rate of 4.4%,and a peak in individuals between 45 and 65 years of age.This study was done to evaluate whether Lian-Zhi-San(LZS),a clinically used anti-hemorrhoidal ointment could alleviate the inflammatory injury,with its associated changes of inflammatory cytokines and morphology of anorectal tissues,in an experimental model of HD in rats.Methods:HD was induced by croton oil preparation(COP)applied to the anorectal region.Rats were then treated with cotton swabs soaked in LZS ointment,water or white vaseline,twice a day for 7 d.At the end of the experiment,HD was evaluated by measuring hemorrhoidal and biochemical parameters along with histopathological observations.Results:In this study,COP induced a significant increase in the macroscopic severity score,anorectal coefficient and Evans blue extravasation,compared to normal rats.Additionally,it greatly enhanced the expression and secretion levels of some important inflammation-related cytokines along with marked histological damage,compared to normal rats.Rats treated with LZS ointment experienced significantly ameliorated Evans blue extravasation(P<0.05),decreased macroscopic severity score(0.86±0.14 vs.1.65±0.16)and the anorectal coefficient(P<0.01);its use also attenuated tissue damage and inhibited the expression and secretion levels of inflammation-related cytokines(interleukin-1 b,interleukin-6 and tumor necrosis factor-a).Conclusion:This study validates a preliminary understanding of the use of LZS ointment to treat inflammatory factors and tissue damage in an experimental model of HD in rats.展开更多
This work was a prospective transversal study over 6 (six) months from May 2 to December 31, 2017 at the Reference Health Center of Commune I and the Chérif la Confessional Health Center in Bamako. The aim was to...This work was a prospective transversal study over 6 (six) months from May 2 to December 31, 2017 at the Reference Health Center of Commune I and the Chérif la Confessional Health Center in Bamako. The aim was to study the knowledge, attitudes and behavioral practices linked to hemorrhoids in Commune I of the Bamako district, to evaluate the frequency of hemorrhoidal disease, to determine the knowledge, attitudes and behavioral practices linked to hemorrhoids among patients, their companions and traditional therapists in Commune I of the district of Bamako and the factors which influence the motivations and decisions to resort to medical-surgical care and traditional medicine in patients suffering from hemorrhoids in order to analyze the results of the management of hemorrhoidal disease at Cs Ref CI. We collected 36 patients with hemorrhoidal disease, 25 caregivers and 15 traditional hemorrhoidal disease therapists. The sex ratio was 1.25 for patients;6.5 for traditional therapists and 1.5 for accompanying people. The average age of the patients was 32.75 years;49 years for traditional therapists and 28.76 years for those accompanying them. 55.6% of patients claim to know about hemorrhoidal disease;100% of traditional therapists and 80% of accompanying people. The dietary factor of hemorrhoidal disease was mentioned by 90% of patients;66.7% of traditional therapists and 100% of caregivers. Most patients initially resorted to traditional treatment out of fear of surgery and its after-effects. The patients were treated medically and surgically.展开更多
Introduction: Hemorrhoidal disease is a common pathology and its surgical treatment is based, among other things, on pedicular resection after failure of medical and instrumental treatment. The aim of this study is to...Introduction: Hemorrhoidal disease is a common pathology and its surgical treatment is based, among other things, on pedicular resection after failure of medical and instrumental treatment. The aim of this study is to analyze the epidemiological, clinical, therapeutic and evolving aspects of hemorrhoidal disease at the stage of surgical treatment at the University Hospital Center of Brazzaville. Patients and Methods: We conducted a retrospective and descriptive study carried out from January 2020 to December 2021, a 24 months period, in the Digestive surgery department of the University Hospital Center of Brazzaville. It concerned patients who underwent a surgical procedure for hemorrhoidal disease. Results: 21 cases were collected, representing a hospital frequency of 2.3%, with a sex ratio of 4.3 in favor of men. The average age of patients was 42.2 ± 11.9 years. The symptoms were mainly proctalgia, mass sensation and rectal bleeding. We recorded five cases (19.1%) of hemorrhoidal thrombosis and 16 cases (80.9%) of hemorrhoidal prolapse including 12 cases requiring manual integration (Goligher grade III) and four irreducible permanent cases (Goligher grade IV). The Grade III prolapse was associated with a polyp in one patient and with posterior anal fissure in another patient. Out of the 21 patients, 14 underwent a tripedicular hemorrhoidectomy according to Milligan and Morgan. Two patients underwent mono- and bipedicular hemorrhoidectomy with resection of associated lesions and five patients underwent emergency thrombectomy. The outcome was favorable for all our patients. The average length of hospital stay was 1.5 ± 2.1 days. Conclusion: In the event of failure of medical and instrumental treatment, the hemorrhoidal cure according to Milligan and Morgan is the surgical treatment of reference for hemorrhoidal disease at the University Hospital Center of Brazzaville.展开更多
Anal pathologies are conditions affecting the anal margin and the anal canal. The aim of our study was to update data on anal diseases. Non-specific, it can reveal an emergency, a serious illness, a chronic disease or...Anal pathologies are conditions affecting the anal margin and the anal canal. The aim of our study was to update data on anal diseases. Non-specific, it can reveal an emergency, a serious illness, a chronic disease or a benign condition. It was a prospective, descriptive and analytical study from April 2022 to March 2023, carried out in the hepato-gastroenterology unit of the Centre de Santé de Référence de la commune V du District de Bamako in Mali. Out of seven hundred and forty-nine (749) patients seen in consultation, 98 had anal pathology, i.e. a prevalence of 13.08%. The mean age was 40 ± 15.15 years and the sex ratio was 1.5. Hemorrhoidal disease and anal fissure were the most frequent pathologies in 66.4% and 24.4% of cases respectively. Medical treatment was initiated in 91.9% of patients with hemorrhoidal disease and 91.7% with anal fissure. Anal pathologies are common in young male patients. In our context, they are dominated by benign conditions.展开更多
Introduction: Gastrointestinal endoscopy plays a crucial role in the management of gastrointestinal diseases. The aim of this study was to report the indications and results of lower digestive endoscopy in a hospital ...Introduction: Gastrointestinal endoscopy plays a crucial role in the management of gastrointestinal diseases. The aim of this study was to report the indications and results of lower digestive endoscopy in a hospital center in Senegal. Patients and Methods: We conducted a descriptive retrospective study from September 1<sup>st</sup>, 2017, to September 30, 2018 at the gastrointestinal endoscopy unit of the regional hospital center of Thiès. All patients received for lower gastrointestinal endoscopy and whose reports were usable, were included. In the reports, we collected and analyzed sociodemographic data, indication and results of the endoscopic examination. Results: We included 250 patients. There were 140 men (sex ratio 1.27). The average age was 42 years [range 1 - 92 years]. There were 37 colonoscopies (14.8%), 51 rectosigmoidoscopies (20.4%) and 162 anorectoscopies (64.8%). The patients were from the region of Thiès in 82% of cases. In most cases, they were most often referred by general practitioners (22.8%) and surgeons (20.8%). The main indications were rectal bleeding (36.8%), hemorrhoidal disease (23.2%) and proctalgia (11.6%). Hemorrhoidal disease (63.6%), anal fistula (14%) and tumors (8.8%) were the most common pathologies. Conclusion: Admitted patients at the gastrointestinal endoscopy unit of the regional hospital center of Thiès have many indications as well as pathologies. Anal pathology is dominated by hemorrhoidal disease.展开更多
Introduction: Hemorrhoids are a frequent and familiar concern of patients in the general practice and surgery settings. Colonoscopy is both diagnostic and therapeutic. In Qatar, There are little data available about c...Introduction: Hemorrhoids are a frequent and familiar concern of patients in the general practice and surgery settings. Colonoscopy is both diagnostic and therapeutic. In Qatar, There are little data available about coincidental pathology in elderly patients with hemorrhoids. Objective: To assess the outcome of colonoscopy in management patients with hemorrhoidal disease and average-risk for colorectal cancer and its clinical significance. Method: A retrospective study of 200 patients with hemorrhoids with average risk colorectal cancer (anal bleeding and anal symptoms) and subjected to colonoscopic examination at Al Khor hospital’s endoscopy unit during the period from May 2005 till August 2012. Patients below 50 years and high risk patients for colorectal cancer;with the following alarm signs: Positive personal history of colorectal neoplasms or Inflammatory Bowel Disease (IBD), positive first degree family history of colorectal neoplasms, history of altered bowel habits, recent significant weight loss, presence of iron deficiency anemia, and history of previous colonoscopy were excluded. All significant endoscopic co-findings (diverticuli, polyps, cancer, angiodysplasia and varices, or colitis) were recorded. Results: There were 200 patients;134 male, 66 female;Mean patient age was 56.3 years (range, 50 to 82 years), who met the eligibility criteria. 200 colonoscopies were performed. Evaluation of these patients revealed Polyps in 16 patients (13 benign and 3 malignant), seven malignant lesions(one annular lesion and 6 fungating masses), Ulcerative colitis in 5 patients, no crohn’s disease, diverticular disease in 4 patients, no Vascular malformations, bleeding piles in 3 patients controlled by injection, and 65.5% of patients were free from any additional pathology. Colonoscopy changed the treatment plan in 58 patients (29%). No complications were encountered. Conclusion: Coincidental abnormalities in colon and rectum in elderly patients with hemorrhoids are common. Benign polyps, followed by diverticular展开更多
<p style="margin-left:10.0pt;"> <span><span><span style="font-family:;" "=""><b><b><span style="font-family:Verdana;">Introduction...<p style="margin-left:10.0pt;"> <span><span><span style="font-family:;" "=""><b><b><span style="font-family:Verdana;">Introduction:</span></b><span></span></b><span style="font-family:Verdana;"> Hemorrhoids, more commonly known as piles, are swollen veins, similar to varicose veins in the lower rectum. Hemorrhoids can develop both inside and outside the rectum, and oftentimes, the cause of hemorrhoids remains unknown. This is an extremely common ailment faced by three out of four adults in their lifetime. Hemorrhoids can cause various kinds of complications, but the most common and serious ones are perianal thrombosis and incarcerated prolapsed internal hemorrhoids with subsequent thrombosis. They are accompanied by severe pain in the perianal region, and possible bleeding. Data on the coexistence of hemorrhoids with other conditions are sparse. Some data are consistent with a common pathophysiological link between straining at stool, constipation, and obstetrical events such as pregnancy and delivery. These events are also involved in the development of Chronic Vein Disease (CVD) or Chronic Vein Insufficiency (CVI). CVI is a condition that occurs when the venous walls or valves in the leg veins stop working properly, causing difficulty in blood returning to the heart from the legs. The present study was conducted with an aim to determine the frequency of complaints in hemorrhoidal patients and to assess the possible concomitance between hemorrhoidal disease and chronic venous disease.</span></span></span></span><span><span><span><span style="font-family:;" "=""> </span></span></span></span><span><span><span><span style="font-family:;" "=""><span><b></b></span><b><b><span style="font-family:Verdana;">Methods:</span></b><span></span></b><span style="font-family:Verdana;"> This was a multicenter, cross-sectional, observational study that enrolled patients spontaneously consulting for hemorrhoids in 17 different hospitals of different regions of Bangladesh from</span></span></span></span></span><span><span><span><sp展开更多
基金Supported by The Intestine Initiative FoundationClinical Science and Technology Foundation of Jiangsu Province,No.BL2014097+1 种基金the National Science and Technology Major Project,No.2012BAI06B03the National Gastroenterology Research Project,No.2015BAI13B07
文摘AIM: To evaluate the methodology, feasibility, safety and efficacy of a novel method called cap-assisted endoscopic sclerotherapy(CAES) for internal hemorrhoids.METHODS: A pilot study on CAES for grade Ⅰ to Ⅲ internal hemorrhoids was performed. Colon and terminal ileum examination by colonoscopy was performed for all patients before starting CAES. Polypectomy and excision of anal papilla fibroma were performed if polyps or anal papilla fibroma were found and assessed to be suitable for resection under endoscopy. CAES was performed based on the requirement of the cap, endoscope, disposable endoscopic long injection needle, enough insufflated air and sclerosing agent.RESULTS: A total of 30 patients with grade Ⅰ to Ⅲ internal hemorrhoids was included. The follow-up was more than four weeks. No bleeding was observed after CAES. One(3.33%) patient claimed mild tenesmus within four days after CAES in that an endoscopist performed this procedure for the first time. One hundred percent of patients were satisfied with this novel procedure, especially for those patients who underwent CAES in conjunction with polypectomy or excision of anal papilla fibroma.CONCLUSION: CAES as a novel endoscopic sclerotherapy should be a convenient, safe and effective flexible endoscopic therapy for internal hemorrhoids.
基金supported by grants from 2018 Annual Program for the Expert Workstation in Healthcare of Jinshan District in Shanghai(No.jszjz2018020Y)the Sixth Period of Key Medical Specialty of Health Commission in Jinshan District in Shanghai(No.JSZK2019A02)。
文摘Objective:Hemorrhoidal disease(HD)is the most common proctological disease,with an estimated prevalence rate of 4.4%,and a peak in individuals between 45 and 65 years of age.This study was done to evaluate whether Lian-Zhi-San(LZS),a clinically used anti-hemorrhoidal ointment could alleviate the inflammatory injury,with its associated changes of inflammatory cytokines and morphology of anorectal tissues,in an experimental model of HD in rats.Methods:HD was induced by croton oil preparation(COP)applied to the anorectal region.Rats were then treated with cotton swabs soaked in LZS ointment,water or white vaseline,twice a day for 7 d.At the end of the experiment,HD was evaluated by measuring hemorrhoidal and biochemical parameters along with histopathological observations.Results:In this study,COP induced a significant increase in the macroscopic severity score,anorectal coefficient and Evans blue extravasation,compared to normal rats.Additionally,it greatly enhanced the expression and secretion levels of some important inflammation-related cytokines along with marked histological damage,compared to normal rats.Rats treated with LZS ointment experienced significantly ameliorated Evans blue extravasation(P<0.05),decreased macroscopic severity score(0.86±0.14 vs.1.65±0.16)and the anorectal coefficient(P<0.01);its use also attenuated tissue damage and inhibited the expression and secretion levels of inflammation-related cytokines(interleukin-1 b,interleukin-6 and tumor necrosis factor-a).Conclusion:This study validates a preliminary understanding of the use of LZS ointment to treat inflammatory factors and tissue damage in an experimental model of HD in rats.
文摘This work was a prospective transversal study over 6 (six) months from May 2 to December 31, 2017 at the Reference Health Center of Commune I and the Chérif la Confessional Health Center in Bamako. The aim was to study the knowledge, attitudes and behavioral practices linked to hemorrhoids in Commune I of the Bamako district, to evaluate the frequency of hemorrhoidal disease, to determine the knowledge, attitudes and behavioral practices linked to hemorrhoids among patients, their companions and traditional therapists in Commune I of the district of Bamako and the factors which influence the motivations and decisions to resort to medical-surgical care and traditional medicine in patients suffering from hemorrhoids in order to analyze the results of the management of hemorrhoidal disease at Cs Ref CI. We collected 36 patients with hemorrhoidal disease, 25 caregivers and 15 traditional hemorrhoidal disease therapists. The sex ratio was 1.25 for patients;6.5 for traditional therapists and 1.5 for accompanying people. The average age of the patients was 32.75 years;49 years for traditional therapists and 28.76 years for those accompanying them. 55.6% of patients claim to know about hemorrhoidal disease;100% of traditional therapists and 80% of accompanying people. The dietary factor of hemorrhoidal disease was mentioned by 90% of patients;66.7% of traditional therapists and 100% of caregivers. Most patients initially resorted to traditional treatment out of fear of surgery and its after-effects. The patients were treated medically and surgically.
文摘Introduction: Hemorrhoidal disease is a common pathology and its surgical treatment is based, among other things, on pedicular resection after failure of medical and instrumental treatment. The aim of this study is to analyze the epidemiological, clinical, therapeutic and evolving aspects of hemorrhoidal disease at the stage of surgical treatment at the University Hospital Center of Brazzaville. Patients and Methods: We conducted a retrospective and descriptive study carried out from January 2020 to December 2021, a 24 months period, in the Digestive surgery department of the University Hospital Center of Brazzaville. It concerned patients who underwent a surgical procedure for hemorrhoidal disease. Results: 21 cases were collected, representing a hospital frequency of 2.3%, with a sex ratio of 4.3 in favor of men. The average age of patients was 42.2 ± 11.9 years. The symptoms were mainly proctalgia, mass sensation and rectal bleeding. We recorded five cases (19.1%) of hemorrhoidal thrombosis and 16 cases (80.9%) of hemorrhoidal prolapse including 12 cases requiring manual integration (Goligher grade III) and four irreducible permanent cases (Goligher grade IV). The Grade III prolapse was associated with a polyp in one patient and with posterior anal fissure in another patient. Out of the 21 patients, 14 underwent a tripedicular hemorrhoidectomy according to Milligan and Morgan. Two patients underwent mono- and bipedicular hemorrhoidectomy with resection of associated lesions and five patients underwent emergency thrombectomy. The outcome was favorable for all our patients. The average length of hospital stay was 1.5 ± 2.1 days. Conclusion: In the event of failure of medical and instrumental treatment, the hemorrhoidal cure according to Milligan and Morgan is the surgical treatment of reference for hemorrhoidal disease at the University Hospital Center of Brazzaville.
文摘Anal pathologies are conditions affecting the anal margin and the anal canal. The aim of our study was to update data on anal diseases. Non-specific, it can reveal an emergency, a serious illness, a chronic disease or a benign condition. It was a prospective, descriptive and analytical study from April 2022 to March 2023, carried out in the hepato-gastroenterology unit of the Centre de Santé de Référence de la commune V du District de Bamako in Mali. Out of seven hundred and forty-nine (749) patients seen in consultation, 98 had anal pathology, i.e. a prevalence of 13.08%. The mean age was 40 ± 15.15 years and the sex ratio was 1.5. Hemorrhoidal disease and anal fissure were the most frequent pathologies in 66.4% and 24.4% of cases respectively. Medical treatment was initiated in 91.9% of patients with hemorrhoidal disease and 91.7% with anal fissure. Anal pathologies are common in young male patients. In our context, they are dominated by benign conditions.
文摘Introduction: Gastrointestinal endoscopy plays a crucial role in the management of gastrointestinal diseases. The aim of this study was to report the indications and results of lower digestive endoscopy in a hospital center in Senegal. Patients and Methods: We conducted a descriptive retrospective study from September 1<sup>st</sup>, 2017, to September 30, 2018 at the gastrointestinal endoscopy unit of the regional hospital center of Thiès. All patients received for lower gastrointestinal endoscopy and whose reports were usable, were included. In the reports, we collected and analyzed sociodemographic data, indication and results of the endoscopic examination. Results: We included 250 patients. There were 140 men (sex ratio 1.27). The average age was 42 years [range 1 - 92 years]. There were 37 colonoscopies (14.8%), 51 rectosigmoidoscopies (20.4%) and 162 anorectoscopies (64.8%). The patients were from the region of Thiès in 82% of cases. In most cases, they were most often referred by general practitioners (22.8%) and surgeons (20.8%). The main indications were rectal bleeding (36.8%), hemorrhoidal disease (23.2%) and proctalgia (11.6%). Hemorrhoidal disease (63.6%), anal fistula (14%) and tumors (8.8%) were the most common pathologies. Conclusion: Admitted patients at the gastrointestinal endoscopy unit of the regional hospital center of Thiès have many indications as well as pathologies. Anal pathology is dominated by hemorrhoidal disease.
文摘Introduction: Hemorrhoids are a frequent and familiar concern of patients in the general practice and surgery settings. Colonoscopy is both diagnostic and therapeutic. In Qatar, There are little data available about coincidental pathology in elderly patients with hemorrhoids. Objective: To assess the outcome of colonoscopy in management patients with hemorrhoidal disease and average-risk for colorectal cancer and its clinical significance. Method: A retrospective study of 200 patients with hemorrhoids with average risk colorectal cancer (anal bleeding and anal symptoms) and subjected to colonoscopic examination at Al Khor hospital’s endoscopy unit during the period from May 2005 till August 2012. Patients below 50 years and high risk patients for colorectal cancer;with the following alarm signs: Positive personal history of colorectal neoplasms or Inflammatory Bowel Disease (IBD), positive first degree family history of colorectal neoplasms, history of altered bowel habits, recent significant weight loss, presence of iron deficiency anemia, and history of previous colonoscopy were excluded. All significant endoscopic co-findings (diverticuli, polyps, cancer, angiodysplasia and varices, or colitis) were recorded. Results: There were 200 patients;134 male, 66 female;Mean patient age was 56.3 years (range, 50 to 82 years), who met the eligibility criteria. 200 colonoscopies were performed. Evaluation of these patients revealed Polyps in 16 patients (13 benign and 3 malignant), seven malignant lesions(one annular lesion and 6 fungating masses), Ulcerative colitis in 5 patients, no crohn’s disease, diverticular disease in 4 patients, no Vascular malformations, bleeding piles in 3 patients controlled by injection, and 65.5% of patients were free from any additional pathology. Colonoscopy changed the treatment plan in 58 patients (29%). No complications were encountered. Conclusion: Coincidental abnormalities in colon and rectum in elderly patients with hemorrhoids are common. Benign polyps, followed by diverticular
文摘<p style="margin-left:10.0pt;"> <span><span><span style="font-family:;" "=""><b><b><span style="font-family:Verdana;">Introduction:</span></b><span></span></b><span style="font-family:Verdana;"> Hemorrhoids, more commonly known as piles, are swollen veins, similar to varicose veins in the lower rectum. Hemorrhoids can develop both inside and outside the rectum, and oftentimes, the cause of hemorrhoids remains unknown. This is an extremely common ailment faced by three out of four adults in their lifetime. Hemorrhoids can cause various kinds of complications, but the most common and serious ones are perianal thrombosis and incarcerated prolapsed internal hemorrhoids with subsequent thrombosis. They are accompanied by severe pain in the perianal region, and possible bleeding. Data on the coexistence of hemorrhoids with other conditions are sparse. Some data are consistent with a common pathophysiological link between straining at stool, constipation, and obstetrical events such as pregnancy and delivery. These events are also involved in the development of Chronic Vein Disease (CVD) or Chronic Vein Insufficiency (CVI). CVI is a condition that occurs when the venous walls or valves in the leg veins stop working properly, causing difficulty in blood returning to the heart from the legs. The present study was conducted with an aim to determine the frequency of complaints in hemorrhoidal patients and to assess the possible concomitance between hemorrhoidal disease and chronic venous disease.</span></span></span></span><span><span><span><span style="font-family:;" "=""> </span></span></span></span><span><span><span><span style="font-family:;" "=""><span><b></b></span><b><b><span style="font-family:Verdana;">Methods:</span></b><span></span></b><span style="font-family:Verdana;"> This was a multicenter, cross-sectional, observational study that enrolled patients spontaneously consulting for hemorrhoids in 17 different hospitals of different regions of Bangladesh from</span></span></span></span></span><span><span><span><sp
