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J A Gracia

Publications and source records attributed to J A Gracia.

4 recordsLinked to original sources
PubMed2005

Doppler-guided hemorrhoidal artery ligation in the management of symptomatic hemorrhoids.

OBJECTIVE: The aim of this study is to clinically test the efficacy of a new approach for patients having symptomatic grade III and IV hemorrhoids. MATERIAL AND METHOD: 32 patients (17 females) complaining of grade III or IV hemorrhoids were included in the study. A specially designed proctoscope coupled with a Doppler transducer on its tip was used to identify the hemorrhoidal arteries, which were afterwards suture ligated. Operating time as well as per- and post-operative complications were analyzed. Follow-up was planned following discharge after 1 week, 1 month, 6 months and 1 year. RESULTS: Mean operation time was 27 (range 18-43) minutes, and 5 (range 4-7) arteries were located on average. No patient had severe or moderate postoperative pain, with anal discomfort being the main complaint. Rectal bleeding and tenesmus were the commonest post-operative complications. After one year of follow-up, 19 patients were free of symptoms and 6 of them had significant symptom relief. According to grade, the technique failed in just 3 grade III patients, but in as many as 4 grade IV hemorrhoid cases. CONCLUSIONS: Doppler-guided hemorrhoid artery ligation is an easy-to-perform technique that is well accepted by patients and has good results for grade III hemorrhoids.

Adult↗
PubMed2005

The utility of endovaginal sonography in the evaluation of fecal incontinence.

OBJECTIVE: The endoanal sonography in female patients with faecal incontinence is sometimes difficult and can lead to diagnostic errors. The aim of this study is to evaluate the value of endovaginal sonography in such cases. MATERIAL AND METHOD: Thirty female patients complaining of faecal incontinence are included in the study. Anal endosonography was performed in all of them in a single ambulatory session, pictures were taken from all along the anal and results were analyzed afterward. Vaginal endosonography was then performed using the same equipment. Result from both techniques were compared. RESULTS: Endoanal sonography was performed in all 30 patients. In 17 cases no anomalies were found. In 3 patients a simple internal anal sphincter defect was found. One case showed a lateral lesion in both sphincters. Six cases presented anterior external defect and in the rest 3 cases a clear view of the anterior wall was impossible. Vaginal endosonography shows a clear image of the anal canal in 23 out of 30 patients. In two cases changed the results of anal endosonography. CONCLUSION: In the study of faecal incontinence, despite of its technical limitations, endovaginal ultrasound could be of help when the anterior wall of the anal canal is not properly defined.

Adult↗