Document Type : Review Articles
Authors
1
Professor of General Surgery, Faculty of Medicine, Zagazig University, Egypt
2
Assistant professor of General Surgery, Faculty of Medicine, Zagazig University, Egypt
3
Department of General Surgery, Faculty of Medicine, Zagazig University, Egypt
4
Lecturer of General Surgery, Faculty of Medicine, Zagazig University, Egypt
Abstract
Background: The most successful treatment for later stages of hemorrhoidal illness is still hemorrhoidectomy, or the surgical removal of hemorrhoids. Postoperative discomfort, on the other hand, is a serious side effect that frequently results in a slower recovery, less patient compliance, and more medical expenses. Numerous tactics have been created to reduce this discomfort and enhance patient results. These include of supportive therapy, medication, and surgical technique adjustments. Although both surgical techniques are still frequently employed, the closed (Ferguson) hemorrhoidectomy has been linked to less pain than the open (Milligan-Morgan) procedure. In order to lessen thermal damage and encourage quicker healing with less postoperative discomfort, innovations like the LigaSureTM and Harmonic Scalpel methods have been developed. Pharmacologically, opioids, non-steroidal anti-inflammatory medications (NSAIDs), and local anesthetics (such bupivacaine or ropivacaine) have all been employed with differing degrees of efficacy. In recent years, topical medications (such as glyceryl trinitrate and diltiazem), injections of botulinum toxin, and oral flavonoids have drawn interest due to their potential to improve vascular tone and decrease sphincter tone. In order to minimize stress and suffering during defecation, supportive measures like stool softeners, high-fiber diets, and warm sitz baths are frequently advised. Conclusion: Despite these options, there is no single gold standard, and individualized treatment protocols are often needed based on patient-specific factors. Researches are needed to optimize multimodal approaches to ensure effective pain control while minimizing drug dependency and enhancing quality of life.
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