| Role of internal sphincterotomy in the treatment of hemorrhoids: a randomized clinical trial. | |
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MedLine Citation:
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PMID: 17903056 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Anal canal dilatation and sphincterotomy have been recommended besides hemorrhoidectomy to overcome the anal pressures in the management of hemorrhoids. The aim of this study to compare internal sphincterotomy and hemorrhoidectomy with hemorrhoidectomy alone with respect to manometric and clinical measures. METHODS: One hundred twenty patients with hemorrhoids were randomly assigned to receive either hemorrhoidectomy with sphincterotomy or hemorrhoidectomy alone. Anal canal pressures including mean squeeze pressure, maximal resting anal canal pressure, and mean resting anal canal pressure, were recorded by manometry before the operation. The patients were evaluated one week and two weeks after the operation clinically and three months later by manometry. RESULTS: The patients were matched with respect to age, gender, and chief complaints. The mean+/-SD age of the patients in hemorrhoidectomy with sphincterotomy group (A) was 43.8+/-14 and in hemorrhoidectomy alone group (B) was 43.94+/-15 years. The male to female ratio was 1.1:1. One week after the operation, there was no statistically significant differences in the frequency of postoperative complications like pain and urinary incontinence between the two groups except for fecal incontinence which was more frequent in group A. After two weeks, the same results with an acceptable improvement in fecal incontinence in group A were observed. Three months after the operation, manometry showed considerable reduction in the mean resting anal canal pressure and maximal resting anal canal pressure in group A; the mean squeeze pressure did not have any changes in either group. CONCLUSION: We recommend sphincterotomy plus hemorrhoidectomy for patients with high anal canal pressure documented by manometry prior to the operation. |
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Authors:
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Seyed Vahid Hosseini; Khosro Sharifi; Azadeh Ahmadfard; Mahnaz Mosallaei; Saeideh Pourahmad; Shahram Bolandparvaz |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Archives of Iranian medicine Volume: 10 ISSN: 1029-2977 ISO Abbreviation: Arch Iran Med Publication Date: 2007 Oct |
Date Detail:
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Created Date: 2007-10-01 Completed Date: 2008-01-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100889644 Medline TA: Arch Iran Med Country: Iran |
Other Details:
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Languages: eng Pagination: 504-8 Citation Subset: IM |
Affiliation:
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Division of Colorectal Surgery, Department of Surgery, Gastroenterohepatology Research Center, Nemazee Hospital, Shiraz, Iran. Mowlaar@gmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anal Canal / surgery* Female Hemorrhoids / therapy* Humans Male Manometry Postoperative Complications Pressure |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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