ABSTRACT
Two hundred twenty-six patients underwent operative hemorrhoidectomy by a single surgeon in a three-year period. In 170 patients (75.2 percent), the operation was performed utilizing the CO2 laser. Standard closed hemorrhoidectomy was done in the rest. Patients were monitored prospectively for postoperative pain, wound healing, and complications. The feasibility of undergoing operative hemorrhoidectomy as an outpatient was also monitored. No differences were seen between laser and nonlaser hemorrhoidectomy. Outpatient surgery was done in over 72 percent of the patients without any added risk to them.
Subject(s)
Hemorrhoids/surgery , Laser Therapy/standards , Pain, Postoperative/epidemiology , Postoperative Complications/epidemiology , Wound Healing , Adult , Aged , Ambulatory Surgical Procedures , Analgesics/administration & dosage , Analgesics/therapeutic use , Arizona/epidemiology , Feasibility Studies , Female , Humans , Laser Therapy/adverse effects , Length of Stay/statistics & numerical data , Male , Middle Aged , Pain, Postoperative/drug therapy , Pain, Postoperative/etiology , Postoperative Complications/etiology , Prospective StudiesABSTRACT
A retrospective study was done comparing the rates of local recurrence in cancer of the rectum treated by low anterior resection using the stapling device or hand-sewn. It was found that there was no increase in recurrences when the stapler was used, even though lower lesions were treated.
Subject(s)
Adenocarcinoma/surgery , Neoplasm Recurrence, Local/etiology , Rectal Neoplasms/surgery , Surgical Staplers , Aged , Female , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/mortality , Retrospective StudiesABSTRACT
The initial experience of several colonic and rectal surgeons with the EEA stapling device for low colorectal anastomoses is reviewed. It was found that the EEA gives a better anastomosis than is possible by hand and that a surgeon familiar with doing a low anterior resection can perform it on patients for whom it is not possible by hand. However, the results with the EEA are not perfect or guaranteed. The many complications associated with its use are reviewed, and ways to avoid them are discussed.
Subject(s)
Colon/surgery , Rectum/surgery , Surgical Staplers , Adolescent , Adult , Aged , Child , Equipment Failure , Female , Humans , Intraoperative Complications , Male , Methods , Middle Aged , Postoperative Complications , Rectal Neoplasms/surgery , Sigmoid Neoplasms/surgery , Surgical Staplers/adverse effectsABSTRACT
Injury to the ureters is a serious complication of colonic and rectal surgery. The experience of the authors with routine use of ureteral catheters to minimize this complication is reviewed. It was found that there are minimal complications associated with their use. Injuries to the ureters were not completely avoided. However, unrecognized injuries (except ischemia) did not occur.
