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At least 127 records · Page 7Linked to original sources

Novel technique: radiofrequency coagulation--a treatment alternative for early-stage hemorrhoids.

BACKGROUND: For early-stage hemorrhoids, in which bleeding is the primary symptom, conventional approaches to management include injection of sclerosing solutions, band ligation, and infrared coagulation. In our study, we used the radiofrequency coagulation technique as an alternative strategy to treat early-stage hemorrhoids. MATERIALS AND METHODS: A total of 210 patients with bleeding hemorrhoids were treated with radiofrequency coagulation at the Gupta Nursing Home in Nagpur, India. RESULTS: Follow-up was at 2 weeks, 3 months, and 12 months after procedure. Results were recorded as follows: (1) Bleeding--Twenty-eight (13%) patients had recurrence of bleeding during the observation period. (2) Pain--Some degree of discomfort was reported by all patients within the first 48 hours. (3) Retention of urine--Only 1 patient had retention of urine; this patient was 74 years old and had an enlarged prostate. (4) Discharge--Thirty-four (16%) patients complained of discharge in the first 2 weeks after procedure. (5) Return to work--Seventy percent (n = 145) of patients resumed their duties after 48 hours; the remainder required 1 additional day. (6) Sepsis--There were no reports of postprocedure sepsis. (7) Sphincter function--None of the patients experienced problems with continence or stenosis. Overall patient satisfaction was 84% (n = 177). CONCLUSION: Although these initial results of coagulation of hemorrhoids by radiofrequency appear quite exciting and encouraging, long-term follow-up is needed to assess the duration of relief and potential side effects. Continued work in this area will likely provide promising new dimensions in the effective management of early-stage hemorrhoids in which bleeding is the main symptom. A separate, randomized trial was carried out to assess the difference in efficacy between infrared coagulation and radiofrequency coagulation in 100 patients with early-stage hemorrhoids. Radiofrequency coagulation was found to be more effective than infrared coagulation in terms of recurrence of bleeding, asymptomatic recurrences of hemorrhoids, and overall satisfaction of technique.

Adolescent↗

[Intervention studies in breast diseases].

Based on results of comprehensive examination of 20,000 females with different breast diseases in a specialized mammological room, the paper presents the most informative invasive techniques that combine diagnostic and therapeutical potentialities, such as ductography, cystography using various sclerosing solution, various types of needle biopsies under X-ray guidance, stereotactic computer devices, ultrasound study, and various labeling modes for nonpalpable formation before surgery. It shows in expedient to make a comprehensive examination under the conditions of a mammological room where the advantages of this or that invisable intervention, including those without a dosage load, are rationally, without duplicating, used depending on the diseases detected, which increases the significance of preoperative diagnosis up to 95-98%, including that of nonpalpable formations by substantially reducing the proportion of surgical interventions into the breast.

Adult↗

Urgent situations in phlebology--variceal bleeding and it's treatment.

The aim of this study was to compare the therapeutic results of patients whose bleeding points were sutured and patients treated with compression sclerotherapy. In the years 1983-2000, 56 patients with profuse bleeding from varicose veins were treated. In a subgroup of patients with compression sclerotherapy--Fegan's way (32 patients), bleeding wound was healed completely within 7 days on average (5-13). All ulcers have healed within 2 months. The presented approach used is a surgical procedure (stitch, removal of large varicosities). Fegan's technique of compression sclerotherapy, with a detergent sclerosing solution (S.T.D.), enables to complete sclerotherapy of all pathological reflux points during 1-2 visits not only with good results, but also as a one-day surgery, keeping the patient work (Ref. 7).

Adult↗

[CT findings and CT-guided puncture of a perineal cyst].

CT findings and treatment results after CT-monitored surgery of a large perineal cyst are described. This was identified as a Müllerian duct cyst which is considered--according to world literature--to be a great rarity. The high rate of relapses even on instillation of sclerosing solutions, as well as differential diagnosis in relation to other perineal cystic space-occupying growths, are discussed.

Adult↗

The short saphenous vein.

If an incompetent short saphenous vein is overlooked during an operation, varicosities invariably recur. A flush saphenopopliteal venous ligation is essential, since it is difficult to eliminate marked valvular insufficiency at this site by injections of a sclerosing solution. The prone position affords excellent exposure of the saphenopopliteal junction. Since the anatomy varies greatly, a flexible approach is desirable. If the anatomy is straightforward and the junction is close to the popliteal space, a transverse skin incision affords excellent exposure and heals well. Although it does not heal as well, a vertical or S-shaped incision is advisable in more complicated instances because it provides better exposure. If all valvular insufficiency is corrected at operation and the patient checked annually so that any new varices can be eliminated by injections, the leg should remain free of varicose veins.

Humans↗

Argon laser treatment of an eyelid margin capillary hemangioma.

When capillary hemangiomas do not resolve spontaneously, treatment may be indicated. Various forms of therapy have been employed. These include excisional surgery, cryotherapy, sclerosing solutions, embolization, external beam irradiation, steroids, and the argon laser. We report the use of a standard ophthalmic argon laser combined with curettage on a noninvoluting eyelid margin hemangioma found on a 29-year-old man. Details of the surgical technique are provided and postoperative results documented. We believe this to be the first case of a lid margin hemangioma successfully treated in this manner. The technique offers these advantages: (1) Selective absorption of the laser energy by the blood-filled tissue allows microablation of the lesion under ideal hemostatic conditions with minimal loss of normal lid tissue. (2) Oculoplastic lid repair is obviated since minimal normal tissue is removed. (3) The procedure can be performed under local anesthesia on an outpatient basis.

Adult↗

Treatment of varicose veins by compression sclerotherapy.

Treatment by compression sclerotherapy was carried out in 80 legs with symptomatic varicose veins. Excellent results were achieved initially in 60 legs, and there was improvement after retreatment of an additional six, for a total of 66 legs. In the remaining 14 legs, there was partial, but considerable, improvement. There were no major complications. Treatment of varicose veins does not necessarily have to be operative. Compression sclerotherapy should be recognized more widely as an acceptable primary treatment aimed at improving local hemodynamics rather than stripping of a vein with good potential for recovery. With the appropriate, not haphazard, use of sclerosing solutions combined with prolonged compression, excellent results usually can be achieved.

Adult↗

Technique for operation upon recurrent varicose veins.

At the time of a secondary operation, every effort should be made to avoid scar tissue from the previous operation. The procedure is relatively simple, if carried out through clean tissue. If an attempt is made to mobilize an incompetent saphenofemoral junction through scar tissue, the procedure can be time-consuming and exceedingly difficult because of the thick scar tissue and thin, friable recurrent varices. In the majority of secondary operations, it was found that the long saphenous vein had not been ligated flush with the femoral vein. In some patients, the long saphenous vein had been ligated properly, but the short saphenous vein or incompetent perforators had been missed. If all venous insufficiency is eliminated at its source, the surgical result should be excellent. Any postoperative residual varices can be eliminated by injections of sclerosing solution. Annual examinations are essential so that if any new varices appear, they can be obliterated by injections.

Anesthesia, General↗

[Diagnosis and treatment of non-parasitic liver cyst].

The experience with treatment of 97 patients with non-parasitary liver cysts by means of percutaneous puncture under guidance of ultrasound investigation and computed tomography has been summarized. The techniques for puncture of non-parasitary liver cysts with drainage and irrigation of a cyst cavity with the solutions of sclerosing substances are presented. The independence of a puncture method of treatment of non-parasitary liver cysts is stressed. A high effectiveness of the method is emphasized.

Adolescent↗

Steroid treatment of an orbital or periocular hemangioma.

Orbital hemangiomas may cause deviation of the visual axis with amblyopia and loss of fusion in the infant as a result. Prior methods of treatment include radiation, injection of sclerosing solutions, surgery and ligation of feeding vessels and systemic steroids. A case is presented of an infant treated at five months of age with systemic prednisone over a six-week period with rapid resolution of an orbital hemangioma.

Female↗

[The prolapse of the rectum. Treatment with fibrin adhesive].

Injection of sclerosing solutions into the rectal submucosa or into the perirectal space is one of the many therapies designed to correct rectal prolapse. Since 1994, four patients affected with this condition have been treated with fibrin adhesive percutaneous injection. Up to now, this product had not been used to this aim. Age range was from 1 month to 8 years. The medium duration of prolapse prior to therapy was 19 months and three of them had an associated pathology (myelomeningocele, cystic fibrosis and severe psychomotor retardation). There were no post-injection complications. In one patient with an irreducible prolapse an anus encirclement with a rectal tube was associated. Except for this patient, the whole process take less than 24 hours. With a medium follow up of 11 months this therapy has resulted effective in three of our four patients. It has failed in a girl with severe psychomotor retardation.

Child↗