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Query: UMLS:C0030201 (Postoperative pain)
 1,085 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Submucosal (SM) and ligation excision (LE) haemorrhoidectomy were compared to establish whether SM is a less painful procedure and whether anal sensation is better preserved by SM, and, if so, how this relates to postoperative function. There were 18 SM and 22 LE patients. Anal sphincter manometry and anal mucosal electrosensitivity were measured pre-operatively and 6 weeks after surgery. Postoperative pain was assessed by linear analogue scale. Anal sphincter pressures which were high pre-operatively fell to normal after surgery. Neither operation affected functional sphincter length or the recto-anal inhibitory reflex. Forty per cent of patients showed ultraslow waves on sphincter motility studies. These were associated with the highest pressures and in all but three cases disappeared after surgery. There were no differences in postoperative pain scores between the two techniques but there was a wide range from no pain to very severe pain in both groups. Submucosal haemorrhoidectomy preserved anal sensation better than ligation excision but this was not reflected in improved function. There was minor leakage and soiling in 50 per cent of patients from both groups and two SM and LE patients had initial faecal incontinence. All these symptoms had resolved by 6 weeks.
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PMID:Submucosal versus ligation excision haemorrhoidectomy: a comparison of anal sensation, anal sphincter manometry and postoperative pain and function. 366 29

The technique of haemorrhoidectomy with the transfixed stitch technique (TST) is a surgical treatment modality for haemorrhoids that is available to the surgeon. The authors, through a personal interpretation of haemorrhoids based on the PATE 2006 classification, report the results of a comparative trial, using TST with two different surgical threads, Assufil and Monofil. The aim of this prospective randomised trial was to compare the results with the use of each surgical thread, analysing early postoperative side effects (bleeding, urinary retention, pain), late postoperative side effects (pain, bleeding, stricture, anal secretion, tenesmus and faecal incontinence), return to active life and quality of life. Patients with grade III-IV haemorrhoids were enrolled in our study and divided into two groups, one treated with TST using Assufil and the other treated with TST using Monofil. The main outcome measures such as analgesic intake during the first week, early and late side effects, return to active life and quality of life were evaluated. Patients were followed for six months after surgery. A total of 40 patients were enrolled, 20 per group. The pain score after surgery was significantly lower in all patients treated with TST. Thirty percent of TST patients treated with Monofil took analgesics in comparison to 35% of the Assufil group (p = ns). Postoperative pain after the start of bowel movements in TST patients was similar in the two groups. TST patients treated with Monofil showed a low incidence of discomfort and surgical oedema in comparison to the Assufil group. Side effects, surgical time and return to active life in patients treated with TST were similar in the two groups. TST haemorrhoidectomy is more advantageous utilising Monofil surgical thread because of its lower complication rate.
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PMID:[Should surgical thread influence the outcome of haemorrhoidectomy with the transfixed stitch technique?]. 1868 81