Self-Mechanical Anal Dilatation: A Simple Trick to Minimize Postoperative Pain and Stenosis Following Hemorrhoidectomy With Radiofrequency
Aim: Hemorrhoidectomy is still the most effective surgical treatment for hemorrhoidal disease, but it is, however, associated with complications such as pain and stenosis. We proposed to break the “vicious circle” of “pain–sphincteric spasm–stenosis–pain” with the postoperative use of self-mechanica...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-08-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2021.711958/full |
| _version_ | 1818729865450356736 |
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| author | Chiara Eberspacher Pietro Mascagni Kenneth Paul Zeri Lisa Fralleone Gabriele Naldini Domenico Mascagni |
| author_facet | Chiara Eberspacher Pietro Mascagni Kenneth Paul Zeri Lisa Fralleone Gabriele Naldini Domenico Mascagni |
| author_sort | Chiara Eberspacher |
| collection | DOAJ |
| description | Aim: Hemorrhoidectomy is still the most effective surgical treatment for hemorrhoidal disease, but it is, however, associated with complications such as pain and stenosis. We proposed to break the “vicious circle” of “pain–sphincteric spasm–stenosis–pain” with the postoperative use of self-mechanical anal dilation.Methods: We retrospectively analyzed patients with hemorrhoidal disease presenting with a minimum of piles of three quadrants, treated with radiofrequency hemorrhoidectomy between January 2018 and December 2019. All the patients that at 3 weeks presented sphincteric spasms with painful defecation, were considered. Thirty-nine patients performed the cycle of self-mechanical anal dilation (Group A). This group was 1:1 matched with homogeneous patients from our historical cohort of patients (Group B). The primary endpoint was the pain evaluation, secondary endpoints: WCS, overall satisfaction of the patient, anal sphincter spasm, scarring, and the incidence of postoperative stenosis.Results: In Group A mean VAS was 3.25 after 14 days of application and 1.15 at the end of the application. In Group B mean VAS was persistently higher, with a mean VAS of 5 (p = 0.000002) and 3.38 (p = 0.0000000000009). In Group A we observed an improvement of symptoms at the end, with a good overall satisfaction (Group A 7.4 vs. Group B 5.9; p = 0.0000007) and a better mean WCS (Group A WCS 2.8 vs. Group B WCS 4.18; p = 0.0001). Stenosis was observed in 3/39 patients of Group B (7.7%).Conclusions: Self-mechanical anal dilation improves the pain in the late postoperative course, minimizing the risk of anal stenosis. |
| first_indexed | 2024-12-17T22:52:41Z |
| format | Article |
| id | doaj.art-76ef387d70b04067bd0305c2d88c5bf4 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-12-17T22:52:41Z |
| publishDate | 2021-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-76ef387d70b04067bd0305c2d88c5bf42022-12-21T21:29:38ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2021-08-01810.3389/fsurg.2021.711958711958Self-Mechanical Anal Dilatation: A Simple Trick to Minimize Postoperative Pain and Stenosis Following Hemorrhoidectomy With RadiofrequencyChiara Eberspacher0Pietro Mascagni1Kenneth Paul Zeri2Lisa Fralleone3Gabriele Naldini4Domenico Mascagni5Department of Surgical Science, Policlinico Umberto I, Sapienza University of Rome, Rome, ItalyIHU-Strasbourg, Institute of Image-Guided Surgery, Strasbourg, FranceVilla Tiberia Hospital, Rome, ItalyDepartment of Surgical Science, Policlinico Umberto I, Sapienza University of Rome, Rome, ItalyProctological and Perineal Surgical Unit, AOU, Cisanello University Hospital, Pisa, ItalyDepartment of Surgical Science, Policlinico Umberto I, Sapienza University of Rome, Rome, ItalyAim: Hemorrhoidectomy is still the most effective surgical treatment for hemorrhoidal disease, but it is, however, associated with complications such as pain and stenosis. We proposed to break the “vicious circle” of “pain–sphincteric spasm–stenosis–pain” with the postoperative use of self-mechanical anal dilation.Methods: We retrospectively analyzed patients with hemorrhoidal disease presenting with a minimum of piles of three quadrants, treated with radiofrequency hemorrhoidectomy between January 2018 and December 2019. All the patients that at 3 weeks presented sphincteric spasms with painful defecation, were considered. Thirty-nine patients performed the cycle of self-mechanical anal dilation (Group A). This group was 1:1 matched with homogeneous patients from our historical cohort of patients (Group B). The primary endpoint was the pain evaluation, secondary endpoints: WCS, overall satisfaction of the patient, anal sphincter spasm, scarring, and the incidence of postoperative stenosis.Results: In Group A mean VAS was 3.25 after 14 days of application and 1.15 at the end of the application. In Group B mean VAS was persistently higher, with a mean VAS of 5 (p = 0.000002) and 3.38 (p = 0.0000000000009). In Group A we observed an improvement of symptoms at the end, with a good overall satisfaction (Group A 7.4 vs. Group B 5.9; p = 0.0000007) and a better mean WCS (Group A WCS 2.8 vs. Group B WCS 4.18; p = 0.0001). Stenosis was observed in 3/39 patients of Group B (7.7%).Conclusions: Self-mechanical anal dilation improves the pain in the late postoperative course, minimizing the risk of anal stenosis.https://www.frontiersin.org/articles/10.3389/fsurg.2021.711958/fullhemorrhoidectomypostoperative painstenosisdilationconstipation |
| spellingShingle | Chiara Eberspacher Pietro Mascagni Kenneth Paul Zeri Lisa Fralleone Gabriele Naldini Domenico Mascagni Self-Mechanical Anal Dilatation: A Simple Trick to Minimize Postoperative Pain and Stenosis Following Hemorrhoidectomy With Radiofrequency Frontiers in Surgery hemorrhoidectomy postoperative pain stenosis dilation constipation |
| title | Self-Mechanical Anal Dilatation: A Simple Trick to Minimize Postoperative Pain and Stenosis Following Hemorrhoidectomy With Radiofrequency |
| title_full | Self-Mechanical Anal Dilatation: A Simple Trick to Minimize Postoperative Pain and Stenosis Following Hemorrhoidectomy With Radiofrequency |
| title_fullStr | Self-Mechanical Anal Dilatation: A Simple Trick to Minimize Postoperative Pain and Stenosis Following Hemorrhoidectomy With Radiofrequency |
| title_full_unstemmed | Self-Mechanical Anal Dilatation: A Simple Trick to Minimize Postoperative Pain and Stenosis Following Hemorrhoidectomy With Radiofrequency |
| title_short | Self-Mechanical Anal Dilatation: A Simple Trick to Minimize Postoperative Pain and Stenosis Following Hemorrhoidectomy With Radiofrequency |
| title_sort | self mechanical anal dilatation a simple trick to minimize postoperative pain and stenosis following hemorrhoidectomy with radiofrequency |
| topic | hemorrhoidectomy postoperative pain stenosis dilation constipation |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2021.711958/full |
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