By Steven D. Wexner
Grasp recommendations mostly surgical procedure: Colon and Rectal surgical procedure: Anorectal Operations is a quantity in a chain that offers universal and complicated tactics within the significant subspecialities of common surgical procedure. The sequence is overseen through Josef F. Fischer, MD, editor of the vintage two-volume reference Mastery of Surgery.
Master suggestions regularly surgical procedure: Colon and Rectal surgical procedure: Anorectal Operations is written through stated grasp surgeons, emphasizes surgeries, and is lavishly illustrated with unique full-color drawings. The members totally clarify their most well liked ideas in step by step, completely illustrated element, check symptoms and contraindications, supply guidance on preoperative making plans, and talk about results, issues, and follow-up.
Coverage comprises hemorrhoidectomies, anal fistula and sphincter systems, techniques for perineal prolapse and excision of rectal carcinoma, between others.
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Extra info for Colon and Rectal Surgery Anorectal Operations
If an adequate three-quadrant Harmonic Scalpel• hemorrhoidectomy is performed, the incidence of "recurrent hemorrhoids" should approach zero. If the entire internal hemorrhoidal component is not carefully excised off the internal sphincter all the way to its apex, soma residual internal component may persist. These patients may experience recurrent bleeding, but this can usually be controlled by rubber-band ligation of the residual hemorrhoid. ~ CONCLUSIONS Harmonic Scalpel• hemorrhoidectomy provides an excellent means of performing an almost "bloodless" hemorrhoidectomy.
36 Part I Hemorrhoidectomy Operating time Hospital stay Postoperative pain Complications Postoperative bleeding Wound healing lime to worlf/nonnal activity Patient satisfaction Costa Recurrent prolapse Reinterventiona for prolapse FavoraPPH FavoraPPH FavorsPPH No difference No difference FavorsPPH FavoraPPH FavorsPPH No difference FavorsCH FavoraCH PPH =procedure for prolapt~e and hemonfloids. * CONCLUSIONS Over the past 12 years, PPH had gained popularity for the surgical treatment of hemorrhoids and/or rectal mucosal prolapse.
10) and Palazzo et al. 8%) of late anal stenosis in patients undergoing LigaSureTM hemorrhoidectomy. Late anal stenosis has been reported in 4-5% of patients after conventional hemorrhoidectomy. Clllptar2 LigaSurelM 3 RESULTS Postoperative Bleeding and Anal Pain Muzi et al. prospectively compared the clinical outcomes of 250 patients with either grade 3 or grade 4 hemorrhoids randomized between LigaSureTM and conventional diathermy hemorrhoidectomy (2). In their study, although not statistically significant, there was a difference between the two groups with respect to postoperative bleeding: postoperative hemorrhage in 3/125 in the LigaSureTM group and 7/125 in the diathermy group.