Diseases of the colon and rectum
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Randomized Controlled Trial Clinical Trial
Randomized, prospective, double-blind, placebo-controlled trial of effect of nitroglycerin ointment on pain after hemorrhoidectomy.
Fissure-in-ano is characterized by pain, bleeding, and internal anal sphincter hypertonicity. Spasm of the internal sphincter also plays a role in hemorrhoidal disease and may be a source of anal pain after hemorrhoid surgery. Inducing sphincter relaxation with a nitroglycerin ointment has shown promise in healing anal fissures and relieving symptoms of pain. Our study attempts to test the hypothesis that topical nitroglycerin applied to the perianal region is beneficial in reducing pain after hemorrhoidectomy. ⋯ Perianal application of 0.2 percent nitroglycerin ointment after hemorrhoidectomy significantly reduced narcotic requirements on the second postoperative day. Headaches and a subsequent need for nonnarcotic medications may limit benefits of nitroglycerin.
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Randomized Controlled Trial Clinical Trial
The WAND local anesthetic delivery system: a more pleasant experience for anal anesthesia.
The WAND is a computer-controlled local anesthetic delivery system. Its use has been proven to be more comfortable for dental patients. The purpose of this study is to explore its applicability to anal procedures. Our hypothesis is that the WAND will provide greater comfort during anesthesia delivery while achieving the same anesthetic effect as traditional syringe technique. ⋯ The WAND is as effective as the traditional syringe technique in the delivery of anal anesthesia while providing a more comfortable experience for the patient.
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Randomized Controlled Trial Comparative Study Clinical Trial
Prospective, randomized trial comparing laparoscopic vs. conventional surgery for refractory ileocolic Crohn's disease.
Surgeons have been reluctant to apply laparoscopic techniques to Crohn's disease surgery because of concerns with evaluating and excising inflamed tissue using laparoscopic methods. Additionally in Crohn's disease surgery, laparoscopic techniques have not been demonstrated to have clear advantages over conventional ones. ⋯ Within a single institution, single surgical team, prospective, randomized trial, laparoscopic techniques offered a faster recovery of pulmonary function, fewer complications, and shorter length of stay compared with conventional surgery for selected patients undergoing ileocolic resection for Crohn's disease.
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Randomized Controlled Trial Clinical Trial
Ketorolac improves recovery after outpatient anorectal surgery.
The purpose of this study was to evaluate the effectiveness of ketorolac combined with local anesthetics for anorectal surgery. ⋯ The addition of ketorolac (60 mg), either intravenous or injected with local anesthetics, reduces voiding problems and significantly decreases postoperative analgesic requirements in outpatients undergoing anorectal surgery.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Bowel preparation with oral polyethylene glycol electrolyte solution vs. no preparation in elective open colorectal surgery: prospective, randomized study.
Efficient mechanical bowel preparation has been regarded as essential in preventing postoperative complications of colorectal surgery, but the necessity of bowel cleansing has been disputed recently. The aim of this study was to evaluate the outcome of elective colorectal surgery in patients with or without bowel preparation. ⋯ Preoperative bowel preparation seems to offer no benefit in elective open colorectal surgery.