Cargando…
Self-Mechanical Anal Dilatation: A Simple Trick to Minimize Postoperative Pain and Stenosis Following Hemorrhoidectomy With Radiofrequency
Aim: Hemorrhoidectomy is still the most effective surgical treatment for hemorrhoidal disease, but it is, however, associated with complications such as pain and stenosis. We proposed to break the “vicious circle” of “pain–sphincteric spasm–stenosis–pain” with the postoperative use of self-mechanica...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8435737/ https://www.ncbi.nlm.nih.gov/pubmed/34527696 http://dx.doi.org/10.3389/fsurg.2021.711958 |
_version_ | 1783751860755103744 |
---|---|
author | Eberspacher, Chiara Mascagni, Pietro Zeri, Kenneth Paul Fralleone, Lisa Naldini, Gabriele Mascagni, Domenico |
author_facet | Eberspacher, Chiara Mascagni, Pietro Zeri, Kenneth Paul Fralleone, Lisa Naldini, Gabriele Mascagni, Domenico |
author_sort | Eberspacher, Chiara |
collection | PubMed |
description | Aim: Hemorrhoidectomy is still the most effective surgical treatment for hemorrhoidal disease, but it is, however, associated with complications such as pain and stenosis. We proposed to break the “vicious circle” of “pain–sphincteric spasm–stenosis–pain” with the postoperative use of self-mechanical anal dilation. Methods: We retrospectively analyzed patients with hemorrhoidal disease presenting with a minimum of piles of three quadrants, treated with radiofrequency hemorrhoidectomy between January 2018 and December 2019. All the patients that at 3 weeks presented sphincteric spasms with painful defecation, were considered. Thirty-nine patients performed the cycle of self-mechanical anal dilation (Group A). This group was 1:1 matched with homogeneous patients from our historical cohort of patients (Group B). The primary endpoint was the pain evaluation, secondary endpoints: WCS, overall satisfaction of the patient, anal sphincter spasm, scarring, and the incidence of postoperative stenosis. Results: In Group A mean VAS was 3.25 after 14 days of application and 1.15 at the end of the application. In Group B mean VAS was persistently higher, with a mean VAS of 5 (p = 0.000002) and 3.38 (p = 0.0000000000009). In Group A we observed an improvement of symptoms at the end, with a good overall satisfaction (Group A 7.4 vs. Group B 5.9; p = 0.0000007) and a better mean WCS (Group A WCS 2.8 vs. Group B WCS 4.18; p = 0.0001). Stenosis was observed in 3/39 patients of Group B (7.7%). Conclusions: Self-mechanical anal dilation improves the pain in the late postoperative course, minimizing the risk of anal stenosis. |
format | Online Article Text |
id | pubmed-8435737 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-84357372021-09-14 Self-Mechanical Anal Dilatation: A Simple Trick to Minimize Postoperative Pain and Stenosis Following Hemorrhoidectomy With Radiofrequency Eberspacher, Chiara Mascagni, Pietro Zeri, Kenneth Paul Fralleone, Lisa Naldini, Gabriele Mascagni, Domenico Front Surg Surgery Aim: Hemorrhoidectomy is still the most effective surgical treatment for hemorrhoidal disease, but it is, however, associated with complications such as pain and stenosis. We proposed to break the “vicious circle” of “pain–sphincteric spasm–stenosis–pain” with the postoperative use of self-mechanical anal dilation. Methods: We retrospectively analyzed patients with hemorrhoidal disease presenting with a minimum of piles of three quadrants, treated with radiofrequency hemorrhoidectomy between January 2018 and December 2019. All the patients that at 3 weeks presented sphincteric spasms with painful defecation, were considered. Thirty-nine patients performed the cycle of self-mechanical anal dilation (Group A). This group was 1:1 matched with homogeneous patients from our historical cohort of patients (Group B). The primary endpoint was the pain evaluation, secondary endpoints: WCS, overall satisfaction of the patient, anal sphincter spasm, scarring, and the incidence of postoperative stenosis. Results: In Group A mean VAS was 3.25 after 14 days of application and 1.15 at the end of the application. In Group B mean VAS was persistently higher, with a mean VAS of 5 (p = 0.000002) and 3.38 (p = 0.0000000000009). In Group A we observed an improvement of symptoms at the end, with a good overall satisfaction (Group A 7.4 vs. Group B 5.9; p = 0.0000007) and a better mean WCS (Group A WCS 2.8 vs. Group B WCS 4.18; p = 0.0001). Stenosis was observed in 3/39 patients of Group B (7.7%). Conclusions: Self-mechanical anal dilation improves the pain in the late postoperative course, minimizing the risk of anal stenosis. Frontiers Media S.A. 2021-08-30 /pmc/articles/PMC8435737/ /pubmed/34527696 http://dx.doi.org/10.3389/fsurg.2021.711958 Text en Copyright © 2021 Eberspacher, Mascagni, Zeri, Fralleone, Naldini and Mascagni. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Surgery Eberspacher, Chiara Mascagni, Pietro Zeri, Kenneth Paul Fralleone, Lisa Naldini, Gabriele Mascagni, Domenico Self-Mechanical Anal Dilatation: A Simple Trick to Minimize Postoperative Pain and Stenosis Following Hemorrhoidectomy With Radiofrequency |
title | Self-Mechanical Anal Dilatation: A Simple Trick to Minimize Postoperative Pain and Stenosis Following Hemorrhoidectomy With Radiofrequency |
title_full | Self-Mechanical Anal Dilatation: A Simple Trick to Minimize Postoperative Pain and Stenosis Following Hemorrhoidectomy With Radiofrequency |
title_fullStr | Self-Mechanical Anal Dilatation: A Simple Trick to Minimize Postoperative Pain and Stenosis Following Hemorrhoidectomy With Radiofrequency |
title_full_unstemmed | Self-Mechanical Anal Dilatation: A Simple Trick to Minimize Postoperative Pain and Stenosis Following Hemorrhoidectomy With Radiofrequency |
title_short | Self-Mechanical Anal Dilatation: A Simple Trick to Minimize Postoperative Pain and Stenosis Following Hemorrhoidectomy With Radiofrequency |
title_sort | self-mechanical anal dilatation: a simple trick to minimize postoperative pain and stenosis following hemorrhoidectomy with radiofrequency |
topic | Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8435737/ https://www.ncbi.nlm.nih.gov/pubmed/34527696 http://dx.doi.org/10.3389/fsurg.2021.711958 |
work_keys_str_mv | AT eberspacherchiara selfmechanicalanaldilatationasimpletricktominimizepostoperativepainandstenosisfollowinghemorrhoidectomywithradiofrequency AT mascagnipietro selfmechanicalanaldilatationasimpletricktominimizepostoperativepainandstenosisfollowinghemorrhoidectomywithradiofrequency AT zerikennethpaul selfmechanicalanaldilatationasimpletricktominimizepostoperativepainandstenosisfollowinghemorrhoidectomywithradiofrequency AT fralleonelisa selfmechanicalanaldilatationasimpletricktominimizepostoperativepainandstenosisfollowinghemorrhoidectomywithradiofrequency AT naldinigabriele selfmechanicalanaldilatationasimpletricktominimizepostoperativepainandstenosisfollowinghemorrhoidectomywithradiofrequency AT mascagnidomenico selfmechanicalanaldilatationasimpletricktominimizepostoperativepainandstenosisfollowinghemorrhoidectomywithradiofrequency |