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General Surgery
Published in Kelvin Yan, Surgical and Anaesthetic Instruments for OSCEs, 2021
These are rare and depend on what procedures have been performed. They can be classified as immediate, early and late complications. Immediate: Patients may experience some discomfort and feel the need for defecation. Bleeding may occur if the mucosa has been damaged.Early: Infection, urinary retention, bleeding and severe pain may occur especially when a rubber band ligation has been done.Late: Recurrence of haemorrhoids/failure of the therapeutic procedure and failure to diagnose cancerous/precancerous lesions.
Management of Internal Hemorrhoids
Published in Stephen M. Cohn, Peter Rhee, 50 Landmark Papers, 2019
Several office procedures exist to address the symptoms of progressive hemorrhoid disease including rubber band ligation, sclerotherapy, and infrared coagulation. Although these treatments may require repeat therapy, they can be offered to temporize symptoms and delay need for definitive treatment in patients with grade II and III disease. Sclerotherapy involves submucosal injection of a sclerosing agent into the apex of the hemorrhoid and relies on subsequent fibrosis to fix the tissue in place and prevent prolapse; however, this modality lacks effectiveness and durability. Rubber band ligation is the most common and effective office procedure performed for the treatment of hemorrhoid disease. In performing this technique, the proximal aspect of the hemorrhoidal tissue is grasped and the rubber bands are applied to the base of the tissue, effectively strangulating the hemorrhoid. In a review of 750 cases of symptomatic grade III or lower hemorrhoids treated with rubber band ligation over an 8-year period, immediate resolution (87%) or symptomatic improvement (6%) was achieved in 93% of patients. Over 85% of patients had 2-year follow-up with a symptomatic recurrence rate of only 11%, and overall a minimal side effect profile from the procedure (El Nakeeb et al., 2008).
Haemorrhoidal Disease
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Austin George Acheson, Oliver Cheong Tsen Ng
Trials looking at infrared photocoagulation show that it is effective and comparable to rubber band ligation and injection sclerotherapy.39,40 It may have fewer short-term complications and less post-operative pain than rubber band ligation, but recurrence is more common.35,41,42 Results compared to injection sclerotherapy showed fewer patients needed additional therapy after injection than after photocoagulation.43
Acute upper gastrointestinal bleeding: a population-based, five-year follow-up study
Published in Scandinavian Journal of Gastroenterology, 2021
Johann P. Hreinsson, Armann Jonsson, Einar S. Bjornsson
Of the 32 AUGIB patients who experienced a rebleed, 34% (11/32) and 6% (2/32) had two and three additional rebleeding events during follow-up, respectively. Common causes of rebleeding were gastric ulcer (16%), oesophagitis (16%) and oesophageal varices (13%), but most commonly unexplained AUGIB 28% (9/32).At index bleeding, all patients with oesophageal varices underwent rubber band ligation therapy (two received injection therapy as well) and of 11 patients with angiodysplasia, 7 (64%) were treated endoscopically. At rebleeding, all patients with variceal bleeding were managed with rubber band ligation and all four patients with oesophagitis had been treated with long-term PPI's. In total, 34/41 (83%) of patients with esophagitis received long-term PPI's. All patients with LA grade C/D (n = 17) and 89% of patients with LA grade A/B were treated with long-term PPI's. Of rebleeders, 40% (13/32) had the same cause of rebleed as index bleeding, most commonly oesophageal varices, 75% (3/4), peptic ulcer 39% (5/13) and angiodysplasia 100% (2/2). Of 123 peptic ulcer patients, 78 (63%) were tested for H. pylori and of those 25 (32%) were positive, with one of them experiencing a rebleed. In univariate comparison, a greater proportion of rebleeders had oesophageal varices and angiodysplasia as a cause of index bleeding but statistical power was low (Table 3). With regard to age, gender, laboratory values, pharmaceutical use, clinically significant bleeding, endoscopic treatment, comorbidities and blood transfusion there were no notable differences between the two groups in univariate (Table 3) and multivariate analysis (data not shown).
Endoscopic management of refractory gastroesophageal reflux disease
Published in Scandinavian Journal of Gastroenterology, 2018
Waseem M. Seleem, Amr Shaaban Hanafy, Samir I. Mohamed
We applied four quadrants rubber band ligation in one session in the band group and the patients were kept on a soft diet and esomeprazole 20 mg daily for 2 weeks. The medical treatment group had received esomeprazole 20 mg twice daily 30 min before meals, bedtime ranitidine 150 mg and baclofen 10 mg twice daily. 2 weeks later, a dramatic improvement of GERD-QoL in patients who were treated by EBL.
Short-Term Results of Sclerotherapy with 3% Polidocanol Foam for Symptomatic Second- and Third-Degree Hemorrhoidal Disease
Published in Journal of Investigative Surgery, 2021
Pierluigi Lobascio, Rita Laforgia, Eugenio Novelli, Fabrizio Perrone, Maria Di Salvo, Angela Pezzolla, Mario Trompetto, Gaetano Gallo
Sclerotherapy (ST) and rubber band ligation (RBL) are the most widely used non-surgical outpatient procedures for the treatment of first-, second- and third degree HD among patients who have failed conservative treatment [5, 6].