M Hulme-Moir | PubMed Health

PubMed2001

Hemorrhoids.

Understanding of hemorrhoidal pathology and treatment has come a long way. The theory of a sliding anal canal lining and the knowledge that hemorrhoidal cushions are a normal part of the anal anatomy should encourage symptom control rather than radical removal of tissue. Techniques that fix the cushions back in position can be performed in outpatients with reasonable success rates. When required, surgery should be aimed at symptomatic hemorrhoids. It is hoped that new developments such as circular stapling and better pain management will promote increased day surgery, better pain control, and less time off work for patients.

Anal Canal↗

PubMed1999

On-the-table colonic lavage.

Single-stage surgery is an acceptable option in the modern management of many acute colonic conditions. Anastomosing unprepared colon is a major concern. A technique is described that allows on-the-table colonic lavage to be performed without contamination of the abdominal cavity.

Colonic Diseases↗

PubMed1998

A prospective audit of Lichtenstein's tension-free herniorrhaphy in Taranaki, New Zealand.

BACKGROUND: This study was undertaken to assess the outcome of Lichtenstein's tension-free mesh inguinal herniorrhaphy as practised by surgeons in a provincial centre in Taranaki, New Zealand. METHODS: A prospective audit was carried out on all patients who underwent this procedure in Taranaki. They were followed up at 1 month and again at 1 year. Results were entered on a standardized pro forma. RESULTS: One hundred and twenty-four patients underwent 134 repairs by four different surgeons and their registrars. Eighty-two per cent of them had a general anaesthetic, and 13% had local anaesthestic. Twenty-five per cent of the repairs were performed as day surgery and a further 53% required overnight stays. Complication rates were 6% in hospital, 12.7% at I month and 8% at 1 year. Recurrence occurred in one repair (0.9%) and there were no cases of mesh rejection. The wound infection rate was 3% and all were minor. Only 45% of the patients who had an inguinal hemiorrhaphy were employed and they took an average of 16 days (range 2-30) to return to work. Over half felt that that they could have returned to normal activities within 2 weeks. CONCLUSIONS: The Lichtenstein technique of inguinal herniorrhaphy is a technically simple, reliable procedure with minimal morbidity and patients may expect a reasonably prompt return to work and to normal activities.

Adolescent↗