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Postoperative outcomes of intrasphincteric botox injection during hemorrhoidectomy: A double-blind clinical trial
BACKGROUND: Pain is the most common postoperative complication of hemorrhoidectomy. We evaluated the effectiveness of intrasphincteric Botox injection on posthemorrhoidectomy complications including pain reduction and wound healing. MATERIALS AND METHODS: In this randomized, double-blind clinical tr...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8506240/ https://www.ncbi.nlm.nih.gov/pubmed/34729061 http://dx.doi.org/10.4103/jrms.JRMS_612_18 |
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author | Alvandipour, Mina Tavallaei, Mehdi Rezaei, Fatemeh Khodabakhsh, Hamed |
author_facet | Alvandipour, Mina Tavallaei, Mehdi Rezaei, Fatemeh Khodabakhsh, Hamed |
author_sort | Alvandipour, Mina |
collection | PubMed |
description | BACKGROUND: Pain is the most common postoperative complication of hemorrhoidectomy. We evaluated the effectiveness of intrasphincteric Botox injection on posthemorrhoidectomy complications including pain reduction and wound healing. MATERIALS AND METHODS: In this randomized, double-blind clinical trial, patients with Grades 3 or 4 symptomatic hemorrhoids who underwent open (Milligan-Morgan) hemorrhoidectomy were enrolled. The experimental group received intrasphincteric Botox injection during hemorrhoidectomy, while the controls received normal saline injection. Hemorrhoid grades, constipation status, history of hemorrhoidectomy, duration of operation, pain at rest and after defecation in six follow-up periods (6, 12, 24, and 48 h and 7 and 14 days after operation), wound healing (during follow-up after discharge with a 2-week period), analgesic use, and Botox side effects were evaluated and compared in the two experimental and control groups. RESULTS: In this trial, 34 and 33 patients were randomly allocated in the experimental and control groups, respectively. Operation time was significantly higher in Botox group (P = 0.009). Mean dose of analgesics use in Botox was significantly lower (P < 0.001). Rate of wound healing during follow-ups was significantly higher in Botox group in the fifth follow-up (P = 0.009). Frequency of urinary retention (P = 0.02) and moderate itching (P = 0.01) was significantly higher in placebo than Botox group. Mean of postoperative pain at rest in Botox group was significantly lower at 12(th), 24(th), and 48(th) h and 7(th) and 14(th) days after operation (P < 0.01). Mean of postoperative pain in Botox group was significantly lower at 3(rd) to 5(th) defecation (P < 0.01). CONCLUSION: Our findings indicated that a single-dose injection of Botox during Milligan-Morgan hemorrhoidectomy is associated with less postsurgical pain at rest and during defecation and improved wound healing. It is suggested that it is a safe and effective procedure during hemorrhoidectomy regarding the procedure-related complications. |
format | Online Article Text |
id | pubmed-8506240 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-85062402021-11-01 Postoperative outcomes of intrasphincteric botox injection during hemorrhoidectomy: A double-blind clinical trial Alvandipour, Mina Tavallaei, Mehdi Rezaei, Fatemeh Khodabakhsh, Hamed J Res Med Sci Original Article BACKGROUND: Pain is the most common postoperative complication of hemorrhoidectomy. We evaluated the effectiveness of intrasphincteric Botox injection on posthemorrhoidectomy complications including pain reduction and wound healing. MATERIALS AND METHODS: In this randomized, double-blind clinical trial, patients with Grades 3 or 4 symptomatic hemorrhoids who underwent open (Milligan-Morgan) hemorrhoidectomy were enrolled. The experimental group received intrasphincteric Botox injection during hemorrhoidectomy, while the controls received normal saline injection. Hemorrhoid grades, constipation status, history of hemorrhoidectomy, duration of operation, pain at rest and after defecation in six follow-up periods (6, 12, 24, and 48 h and 7 and 14 days after operation), wound healing (during follow-up after discharge with a 2-week period), analgesic use, and Botox side effects were evaluated and compared in the two experimental and control groups. RESULTS: In this trial, 34 and 33 patients were randomly allocated in the experimental and control groups, respectively. Operation time was significantly higher in Botox group (P = 0.009). Mean dose of analgesics use in Botox was significantly lower (P < 0.001). Rate of wound healing during follow-ups was significantly higher in Botox group in the fifth follow-up (P = 0.009). Frequency of urinary retention (P = 0.02) and moderate itching (P = 0.01) was significantly higher in placebo than Botox group. Mean of postoperative pain at rest in Botox group was significantly lower at 12(th), 24(th), and 48(th) h and 7(th) and 14(th) days after operation (P < 0.01). Mean of postoperative pain in Botox group was significantly lower at 3(rd) to 5(th) defecation (P < 0.01). CONCLUSION: Our findings indicated that a single-dose injection of Botox during Milligan-Morgan hemorrhoidectomy is associated with less postsurgical pain at rest and during defecation and improved wound healing. It is suggested that it is a safe and effective procedure during hemorrhoidectomy regarding the procedure-related complications. Wolters Kluwer - Medknow 2021-08-30 /pmc/articles/PMC8506240/ /pubmed/34729061 http://dx.doi.org/10.4103/jrms.JRMS_612_18 Text en Copyright: © 2021 Journal of Research in Medical Sciences https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Alvandipour, Mina Tavallaei, Mehdi Rezaei, Fatemeh Khodabakhsh, Hamed Postoperative outcomes of intrasphincteric botox injection during hemorrhoidectomy: A double-blind clinical trial |
title | Postoperative outcomes of intrasphincteric botox injection during hemorrhoidectomy: A double-blind clinical trial |
title_full | Postoperative outcomes of intrasphincteric botox injection during hemorrhoidectomy: A double-blind clinical trial |
title_fullStr | Postoperative outcomes of intrasphincteric botox injection during hemorrhoidectomy: A double-blind clinical trial |
title_full_unstemmed | Postoperative outcomes of intrasphincteric botox injection during hemorrhoidectomy: A double-blind clinical trial |
title_short | Postoperative outcomes of intrasphincteric botox injection during hemorrhoidectomy: A double-blind clinical trial |
title_sort | postoperative outcomes of intrasphincteric botox injection during hemorrhoidectomy: a double-blind clinical trial |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8506240/ https://www.ncbi.nlm.nih.gov/pubmed/34729061 http://dx.doi.org/10.4103/jrms.JRMS_612_18 |
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