ABSTRACT
Stapled Hemorrhoidectomy is when correctly indicated an easy feasible operative procedure for prolapsing internal hemorrhoids with or without a mucosal prolapse offering benefits to the patient. From July 1998 to October 2000 we treated 152 patients with a mean age of 52 (24-91) years for hemorrhoids within this study. We compared 72 patients, treated with stapled hemorrhoidectomy according to Koblandin-Longo with 80 patients who underwent a "conventional" reconstructive operation (Parks or Fansler-Arnold). All resected material was histopathologically examined. With stapler hemorrhoidectomy we found on average shorter operation times (22 vs. 53 min, p < 0.01), shorter hospitalisation (3 vs. 6.1 d, p < 0.01), significantly less postoperative pain (VAS 0-10: 1.83 vs. 3.70, p < 0.01) and fewer cumulative requests for analgesia by the patients (0.92 vs. 3.11 single doses, p < 0.01). The complication rate was 4 % in the stapler group and 11 % in the conventional group. Stapled hemorrhoidectomy was carried out only in patients with 3 degrees hemorrhoids with or without mucosal prolapse. The conventional group consisted of patients with 3 degrees prolapsing or 4 degrees fixated external hemorrhoids. Although very promising results are actually described with stapler hemorrhoidectomy, the established conventional reconstructive operations should be continued until long-term results are published.
Subject(s)
Hemorrhoids/surgery , Postoperative Complications/etiology , Surgical Staplers , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Length of Stay , Male , Middle Aged , Outcome and Process Assessment, Health Care , Pain, Postoperative/etiology , Rectal Prolapse/surgeryABSTRACT
The acoustic effects of three different configurations of vented in-the-canal (ITC) hearing aid shells were investigated. Real-ear sound pressure level measures (200-2000 Hz) were obtained from unvented and vented ITC shells from 12 adult subjects. In general, with increasing vent size, an increase in the amount of low-frequency reduction and an upward shift in vent kneepoints and vent-associated resonance occurred. The use of venting may be considered clinically for low-frequency reduction in ITC hearing aid frequency responses.
