Search Result for "CAG"

Hemorrhoidectomy surgery, a medical procedure aimed at eliminating internal or external hemorrhoids of significant extent or severity, stands as the most efficacious means to address this condition, although it carries the highest risk of complications.This surgical intervention becomes necessary under the following circumstances:When symptomatic grade III, grade IV, or mixed internal and external hemorrhoids manifest.In the presence of concurrent anorectal conditions requiring surgical intervention.In cases of strangulated internal hemorrhoids.For certain thrombosed external hemorrhoids.When patients either cannot endure or fail minimally invasive treatments.Various types of hemorrhoidectomies and associated procedures are performed during this surgery:Closed Hemorrhoidectomy:Closed hemorrhoidectomy represents the most commonly utilized surgical approach for internal hemorrhoid treatment. It involves the excision of hemorrhoidal bundles using a sharp tool such as a scalpel, scissors, electrocautery, or even a laser. This is followed by complete wound closure using absorbable sutures. Typically, all three hemorrhoidal columns are treated simultaneously. Postoperative care entails frequent sitz baths, mild pain relievers, and the prevention of constipation. Closed hemorrhoidectomy boasts a success rate of 95%. Potential complications may include pain, delayed bleeding, urinary retention/urinary tract infections, fecal impaction, and exceptionally rare occurrences of infection, wound breakdown, fecal incontinence, and anal stricture. While this technique causes the most postoperative discomfort and pain, it yields the best long-term results with the lowest recurrence rates. Ongoing efforts are being made to reduce post-surgical pain, promising an improved patient experience.Open Hemorrhoidectomy:Open hemorrhoidectomy entails the excision of hemorrhoidal tissue in a manner similar to the closed procedure, but the incision is left open. Surgeons may choose an open hemorrhoidectomy when wound closure is challenging due to the location or extent of the disease or when the risk of postoperative infection is high. Frequently, a combination of open and closed techniques is employed. Complications following open hemorrhoidectomy mirror those of the closed procedure.Stapled Hemorrhoidectomy for Prolapsing Hemorrhoids:Stapled hemorrhoidectomy, also known as Longo's procedure, the procedure for prolapse and hemorrhoids (PPH), stapled circumferential mucosectomy, or circular stapler hemorrhoidopexy, is a recent addition to the surgical options for internal hemorrhoids. It is mainly employed in patients with grade III and IV hemorrhoids and those who have not responded to prior minimally invasive treatments. During this procedure, a circular stapling device is used to excise a circumferential ring of excess hemorrhoid tissue, returning hemorrhoids to their normal position within the anal canal. Stapling also disrupts the blood supply to the hemorrhoids. Studies suggest that stapled hemorrhoidectomy results in reduced postoperative pain and quicker recovery compared to conventional surgery, but it carries a higher risk of recurrence. The frequency of complications is similar to that observed with standard hemorrhoidectomy.Rubber Band Ligation:Rubber band ligation involves placing a rubber band around the base of the hemorrhoid inside the rectum. This band cuts off the circulation, causing the hemorrhoid to wither away within a few days.Lateral Internal Sphincterotomy:Lateral internal sphincterotomy, which involves the incision of the inner anal sphincter muscle, is occasionally performed during hemorrhoidectomy in patients with elevated resting sphincter pressures. The intention behind this procedure is to reduce postoperative pain, although it is not commonly employed in most cases.In conclusion, hemorrhoidectomy surgery is a vital medical procedure employed for the removal of internal or external hemorrhoids that are extensive or severe in nature. While it holds the distinction of being the most effective treatment for hemorrhoids, it is important to note that it comes with a relatively high rate of complications. This surgical intervention is considered necessary in cases of symptomatic grade III, grade IV, or mixed internal and external hemorrhoids, when there are concurrent anorectal conditions requiring surgical attention, when internal hemorrhoids become strangulated, for certain thrombosed external hemorrhoids, and when patients cannot tolerate or do not respond to minimally invasive treatment options.