Diseases of the colon and rectum
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Randomized Controlled Trial
Effect of prednisolone on local and systemic response in laparoscopic vs. open colon surgery: a randomized, double-blind, placebo-controlled trial.
This study was designed to assess whether preoperative, short-term, intravenously administered high doses of methylprednisolone (30 mg/kg 90 minutes before surgery) influence local and systemic biohumoral responses in patients undergoing laparoscopic or open resection of colon cancer. ⋯ Preoperative administration of methylprednisolone in colon cancer patients may improve pulmonary performance and postoperative pain, and shorten length of stay regardless of the surgical technique used (laparoscopy, open colon resection).
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Randomized Controlled Trial Comparative Study
Unroofing and marsupialization vs. rhomboid excision and Limberg flap in pilonidal disease: a prospective, randomized, clinical trial.
The aim of the study was to compare clinical outcomes and quality of life in patients undergoing surgery for pilonidal disease with unroofing and marsupialization (UM) or rhomboid excision and Limberg flap (RELP) procedures. ⋯ The unroofing and marsupialization procedure provides more clinical benefits in the treatment of pilonidal disease than rhomboid excision and Limberg flap and should be considered the procedure of choice. However, it may be associated with more inconvenience in wound care and longer healing time than rhomboid excision and Lindberg flap.
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Randomized Controlled Trial
The effect of glyceryl trinitrate ointment on posthemorrhoidectomy pain and wound healing: results of a randomized, double-blind, placebo-controlled study.
Spasm of the internal sphincter may be a source of anal pain and delayed healing after hemorrhoidectomy. This study assessed whether glyceryl trinitrate (GTN) ointment reduces pain and promotes wound healing after hemorrhoidectomy. ⋯ Compared with placebo, perianal application of 0.2 percent GTN ointment significantly decreases postoperative pain after hemorrhoidectomy and reduces analgesic requirements in the immediate postoperative period. GTN ointment also achieves more rapid healing of wounds.
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Randomized Controlled Trial
Sacral nerve stimulation is more effective than optimal medical therapy for severe fecal incontinence: a randomized, controlled study.
This randomized study was designed to compare the effect of sacral neuromodulation with optimal medical therapy in patients with severe fecal incontinence. ⋯ Sacral neuromodulation significantly improved the outcome in patients with severe fecal incontinence compared with the control group undergoing optimal medical therapy.
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Randomized Controlled Trial Comparative Study
Stapled technique for acute thrombosed hemorrhoids: a randomized, controlled trial with long-term results.
This study was designed to compare stapled vs. conventional hemorrhoidectomy for patients with acute thrombosed hemorrhoids. ⋯ Stapled hemorrhoidectomy is safe and effective for acute thrombosed hemorrhoids. Similar to elective stapled procedure, emergency stapled excision has greater short-term benefits compared with conventional excision: diminished pain, faster recovery, and earlier return to work. Long-term results and satisfaction were excellent.