Short- and long-term results of harmonic scalpel hemorrhoidectomy versus stapler hemorrhoidopexy in treatment of hemorrhoidal disease

SummaryPurposeIn this prospective randomized study, our aim is to compare the short- and long-term results of harmonic scalpel hemorrhoidectomy (HSH) and stapler hemorrhoidopexy (SH) methods in the surgical treatment of Grade III and Grade IV hemorrhoidal disease.MethodsNinety-nine consecutive patients diagnosed with Grade III or Grade IV internal hemorrhoidal disease were included in the study. Patients were randomized to HSH (n = 48) or SH (n = 51) treatments. Data on patient demographic and clinical characteristics, operative details, postoperative pain score on a visual analog scale, additional analgesic requirement, postoperative short- and long-term complications, and recurrence of hemorrhoidal disease were also recorded. Patients were regularly followed for a total period of 24 (6–36) months.ResultsThe patient demographic and clinical characteristics were similar in the two groups. The operative time was significantly shorter in the HSH group compared with the SH group. Overall pain scores were not significantly different between the groups, although severe pain was significantly more common in the HSH group. Recurrence was significantly lower in the HSH group compared with the SH group.ConclusionHSH and SH are both safe and effective methods for surgical treatment of Grade III and Grade IV hemorrhoidal disease. In our study, the HSH method was determined to be safer, easier, and faster to perform, and associated with fewer long-term recurrences than the SH method

Hand-assisted retroperitoneoscopic donor nephrectomy offers more liberal use of right kidneys: Lessons learned from 565 cases - a retrospective single-center study

The introduction of laparoscopic donor nephrectomy caused a shift toward, left donor nephrectomy. Some centers report a significantly low rate of endoscopic right donor nephrectomy. Hand-assisted retroperitoneoscopic donor nephrectomy (HARP-DN) was introduced as a novel surgical technique, which aims to avoid intra-abdominal complications. It was also reported to provide technical advantages for right-sided DN. In this retrospective single-center study, we evaluated the impact of HARP-DN technique on utilization of right-sided DNs. After the implementation of HARP-DN on February 2009, a total of 565 DNs were performed until December 2015. The introduction of HARP-DN technique resulted in an immediate increase in the utilization of right kidneys from 6.1% to an average of 19.6% annually. The donors 'outcome was similar to the left-sided and right-sided DN groups, excluding the increased incidence of incisional hernias in left kidney donors. None of the donors developed intra-abdominal complications. In conclusion, the implementation of HARP technique significantly increased the use of right-sided DNs, which enables a more liberal use of donors in LDKT

Position of simultaneous kidney and pancreas transplantation in treatment of diabetes accompanied with end-stage renal failure: case discussion and new approaches

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Tip 1 diyabet, mikrovasküler ve makrovasküler komplikasyonlarla ilerleyen hastayı son dönem böbrek yetmezliğine götürebilen, pankreas adacık hücrelerinin kaybıyla karakterize otoimmün bir hastalıktır. Diyaliz ve insülin tedavisi, bu hastalara yaşama şansı tanırken, düşük yaşam kalitesi ve ilerleyici komplikasyonlar hastaları en çok zorlayan etkenlerdir. Eş zamanlı pankreas-böbrek nakli, bu grup hastada, hastanın yaşam kalitesini ve süresini artıran, normoglisemik kan düzeyiyle diyalizden bağımsız yaşamı sağlayan en önemli tedavi yöntemidir. Bu yazıda, eş zamanlı pankreas-böbrek nakli gerçekleştirilen bir olguyu, ameliyat tekniğini, tedavi sonuçlarını ve yeni yaklaşımları değerlendirdik.Type 1 diabetes, characterized with the loss of pancreatic islet cells and advanced with microvascular and macrovascular complications, is an autoimmune disease that can cause end stage renal failure. These patients have a chance to survive with hemodialysis and insulin therapy, but they may suffer from many co-morbidities and low quality of life. In this group of patients, simultaneous pancreas kidney transplantation is the only treatment modality that improves the quality and duration of life, providing normo-glycemic blood levels and dialysis-free life span. In this paper, we reviewed a simultaneous pancreas kidney transplanted case, the operation technique, treatment outcomes, and new trends

THE USE OF HAND ASSISTED RETROPERITONEOSCOPIC NEPHRECTOMY TECHNIQUE FOR SINGLE INCISION SIMULTANEOUS NATIVE NEPHRECTOMY AND LIVING DONOR KIDNEY TRANSPLANTATION: REPORT OF TWO CASES

WOS: 000411688503410

Clinical evaluation of a temporary fecal containment device for non-surgical fecal diversion in perineal burns

BACKGROUND The aim of this study was to evaluate the clinical results of a temporary fecal containment device (Flexi-Seal (R) FMS) in our burn center

Clinical evaluation of a temporary fecal containment device for non-surgical fecal diversion in perineal burns

BACKGROUND The aim of this study was to evaluate the clinical results of a temporary fecal containment device (Flexi-Seal (R) FMS) in our burn center

Short- and long-term results of harmonic scalpel hemorrhoidectomy versus stapler hemorrhoidopexy in treatment of hemorrhoidal disease

In this prospective randomized study, our aim is to compare the short- and long-term results of harmonic scalpel hemorrhoidectomy (HSH) and stapler hemorrhoidopexy (SH) methods in the surgical treatment of Grade III and Grade IV hemorrhoidal disease. Ninety-nine consecutive patients diagnosed with Grade III or Grade IV internal hemorrhoidal disease were included in the study. Patients were randomized to HSH (n = 48) or SH (n = 51) treatments. Data on patient demographic and clinical characteristics, operative details, postoperative pain score on a visual analog scale, additional analgesic requirement, postoperative short- and long-term complications, and recurrence of hemorrhoidal disease were also recorded. Patients were regularly followed for a total period of 24 (6–36) months. The patient demographic and clinical characteristics were similar in the two groups. The operative time was significantly shorter in the HSH group compared with the SH group. Overall pain scores were not significantly different between the groups, although severe pain was significantly more common in the HSH group. Recurrence was significantly lower in the HSH group compared with the SH group. HSH and SH are both safe and effective methods for surgical treatment of Grade III and Grade IV hemorrhoidal disease. In our study, the HSH method was determined to be safer, easier, and faster to perform, and associated with fewer long-term recurrences than the SH method

Incisional Complications and Cosmetic Evaluation After Hand-assisted Retroperitoneoscopic Donor Nephrectomy

1st International Transplant Network Congress -- OCT 17-21, 2018 -- Antalya, TURKEYAydogdu, Ibrahim/0000-0001-7900-8598; SARDOGAN, CEYDA/0000-0002-4263-3653WOS: 000487349900018PubMed: 31474288Purpose. Hand-assisted retroperitoneoscopic (HARP) donor nephrectomy prevents major complications, but incision site complications may be more frequent in hand-assisted approach. We evaluated long-term incisional complication rates and cosmetic outcomes after HARP donor nephrectomy in our series. Materials and Methods. A total of 609 donors who underwent nephrectomy between February 2009 and June 2016 were invited for physical examination and face-to-face interview. A total of 209 donors (35.3%) participated to the study. Sex, age, body mass index (BMI), mean follow-up period, incision-related outcomes of cosmesis, and postoperative complications were evaluated. Body image scale (BIS) and cosmetic scale (CS) (scar test) questionnaires were applied. Higher cosmesis and body image scores indicated greater satisfaction. Results. A total of 191 donors had paramedian (91.4%), and 18 donors had Pfannenstiel incision (8.6%); 121 donors were female (57.9%). the donor mean age and BMI were 49.1 (SD, 1.8) years and 29.7 (SD, 5.1), respectively. Body mass index was significantly lower in the Pfannenstiel group (P < .001). the mean BIS score was 18.9 (SD, 1.8), and the CS questionnaire score was 19.3 (SD, 4,7). the BIS score was significantly better in donors with Pfannenstiel incisions (P < .001), but there was no statistical significance in CS score. the total rate of wound infection was 4.8%, and rate of incisional hernia was 4.8%. the rate of incisional hernia was more frequent in donors with paramedian incision (5.2%), but there was no statistical significance. Six donors (2.9%) required rehospitalization because of incision site complications. Conclusion. Hand-assisted retroperitoneoscopic donor nephrectomy avoids intra-abdominal complications, but rate of incision site complications can be higher in hand-assisted procedure. the donors were convinced from the cosmetic outcome after HARP donor nephrectomy. the ones who had Pfannenstiel incision had better satisfaction according to BIS score