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Hemorrhoid Coagulation

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41. Hemorrhoidal Artery Ligation and Rectoanal Repair Versus Stapled Hemorrhoidopexy

for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria: hemorrhoids grade 3 no active anti-coagulation treatment no hemorrhoidal recurrence no previous surgery on rectum or anus no previous local radiotherapy no mental incapacities, good study compliance can be expected no severe incontinence (Wexner score > 12) no severe comorbidities no inflammatory anal diseases (abscesses, fistulas) informed consent Exclusion Criteria: patient wish inoperability with the assigned intervention (...) Hemorrhoidal Artery Ligation and Rectoanal Repair Versus Stapled Hemorrhoidopexy Hemorrhoidal Artery Ligation and Rectoanal Repair Versus Stapled Hemorrhoidopexy - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding

2012 Clinical Trials

42. Randomized prospective study of endoscopic rubber band ligation compared with bipolar coagulation for chronically bleeding internal hemorrhoids (PubMed)

Randomized prospective study of endoscopic rubber band ligation compared with bipolar coagulation for chronically bleeding internal hemorrhoids Our purpose was to compare the efficacy, complications, success rate, recurrence rate at 1 year, and crossovers of rubber band ligation (RBL) with those of bipolar electrocoagulation (BPEC) treatment for chronically bleeding internal hemorrhoids.A total of 45 patients of mean age 51.5 years, who had rectal bleeding from grade II or III hemorrhoids (...) and in whom intensive medical therapy failed, were randomized in a prospective study comparing RBL with BPEC. Treatment failure was predefined as continued bleeding, occurrence of a major complication, or failure to reduce the size of all internal hemorrhoidal segments to grade I in < or =3 treatments. Patients were followed up for 1 year.With similar patients, rectal bleeding and other symptoms were controlled with significantly fewer treatments of RBL than of BPEC (2.3+/-0.2 vs. 3.8+/-0.4, P<0.05

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2009 EvidenceUpdates

43. Comparison Between Single and Triple Rubber Band Ligation for the Treatment of Hemorrhoids

Accepts Healthy Volunteers: No Criteria Inclusion Criteria: Patients with second-degree hemorrhoids Exclusion Criteria: Patients with special needs Immunodepression Indians Infectious, inflammatory or tumoral anorectal comorbidities Previous anorectal surgeries Patients on anticoagulant therapy or with coagulation disorders Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using (...) Comparison Between Single and Triple Rubber Band Ligation for the Treatment of Hemorrhoids Comparison Between Single and Triple Rubber Band Ligation for the Treatment of Hemorrhoids - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more

2011 Clinical Trials

44. Comparison Study of Surgical Staplers for the Treatment of Hemorrhoids

Comparison Study of Surgical Staplers for the Treatment of Hemorrhoids Comparison Study of Surgical Staplers for the Treatment of Hemorrhoids - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Comparison Study (...) of Surgical Staplers for the Treatment of Hemorrhoids (HEMOSTASIS) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT01306877 Recruitment Status : Completed First Posted : March 2, 2011 Results First Posted : October 29, 2014 Last Update Posted : October 29, 2014 Sponsor: Medtronic - MITG Information

2011 Clinical Trials

45. Safety and Short Term Effectiveness of EEA Versus PPH Stapler for III Degree Hemorrhoids

informed consent mental ability to understand the procedure Exclusion Criteria: Previous treatments for hemorrhoids or other proctological diseases Fecal Incontinence Chronic inflammatory bowel disease Anal sphincter lesions coagulative defects obstructed defecation Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer (...) Safety and Short Term Effectiveness of EEA Versus PPH Stapler for III Degree Hemorrhoids Safety and Short Term Effectiveness of EEA Versus PPH Stapler for III Degree Hemorrhoids - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies

2011 Clinical Trials

46. Diathermy excisional hemorrhoidectomy: a prospective randomized study comparing pedicle ligation and pedicle coagulation. (PubMed)

clinical trial.Patients were treated at a single tertiary-level teaching hospital (Main University Hospital) in Alexandria, Egypt, from February 2009 to October 2010.Patients with symptomatic grade III or IV hemorrhoids were eligible.Patients were randomly allocated to receive either pedicle coagulation or pedicle ligation during 3-quadrant diathermy excision hemorrhoidectomy.Patients reported postoperative pain daily on a visual analog scale (0-10, with 10 corresponding to the most severe pain) during (...) Diathermy excisional hemorrhoidectomy: a prospective randomized study comparing pedicle ligation and pedicle coagulation. In hemorrhoidectomy, pedicle coagulation has been claimed to be associated with less postoperative pain compared with pedicle ligation.This study was designed to compare the effects of pedicle ligation vs pedicle coagulation on postoperative pain in patients undergoing diathermy excisional hemorrhoidectomy.The study was conducted as a single-blind prospective randomized

2011 Diseases of the colon and rectum

47. Trans-anal Hemorrhoidal Dearterialization (THD) vs. Hemorrhoidectomy

Trans-anal Hemorrhoidal Dearterialization (THD) vs. Hemorrhoidectomy Trans-anal Hemorrhoidal Dearterialization (THD) vs. Hemorrhoidectomy - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Trans-anal (...) Hemorrhoidal Dearterialization (THD) vs. Hemorrhoidectomy (THD) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT01244672 Recruitment Status : Completed First Posted : November 19, 2010 Last Update Posted : October 5, 2012 Sponsor: Stony Brook University Information provided by (Responsible Party): Roberto

2010 Clinical Trials

48. Safety and Performance of the Covidien EEA Hemorrhoid and Prolapse Stapling Set in a Hemorrhoidopexy Procedure

Safety and Performance of the Covidien EEA Hemorrhoid and Prolapse Stapling Set in a Hemorrhoidopexy Procedure Safety and Performance of the Covidien EEA Hemorrhoid and Prolapse Stapling Set in a Hemorrhoidopexy Procedure - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved (...) studies (100). Please remove one or more studies before adding more. Safety and Performance of the Covidien EEA Hemorrhoid and Prolapse Stapling Set in a Hemorrhoidopexy Procedure The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT01169311 Recruitment Status : Completed First Posted : July 26, 2010

2010 Clinical Trials

49. Diagnosis and management of acute lower gastrointestinal bleeding

, retrospective, proof of concept study). 40 CO 2 with gas exchange should be used to reduce gas explosion risk in poorly prepared colons, and diathermy or argon plasma coagulation use should be carefully considered. Endoscopic options for diverticular bleeding at colonoscopy include injection therapy—for example, epinephrine, endoscopic clipping (through- and over-the-scope), thermal therapies such as bipolar coagulation or argon plasma coagulation, and endo- scopic band ligation, endoloops or haemostatic (...) which may drain directly into the systemic circulation. ? Through-the-scope clips should be considered first-line treatment for diverticular bleeding as they are widely avail- able, rapid to deploy, low risk and clinically effective. 78 ? For bipolar coagulation use lower power, less pressure and shorter pulses than in the UGI tract—for example, Gold Probe (Boston Scientific) with ERBE VIO 10–15 W, 2 s pulses until vessel flattening. 26 31 ? Argon plasma coagulation should be used at lower gas flow

2019 British Society of Gastroenterology

50. Guideline regarding treatment of haemorrhoids

4.6 Recommendations for diagnostic assessment 17 5. Basic treatment for haemorrhoids 19 5.1 Introduction 19 5.2 Review questions 19 5.3 Interventions 20 5.3.1 Toilet training 20 5.3.2 Laxatives intake 20 5.3.3 Local anaesthetics 20 5.3.4 Phlebotonics 20 5.3.5 Other 21 5.4 GRADE 21 3 5.5 Recommendations for basic treatment 23 6 Outpatient procedures 24 6.1 Introduction 24 6.2 Review questions 24 6.3 Techniques 25 6.3.1 Rubber band ligation (RBL) 25 6.3.2 Infrared coagulation (IRC) 25 6.3.3 (...) Injection sclerotherapy (SCL) 25 6.4 Evidence in the literature 25 6.4.1 Rubber Band Ligation (RBL) versus Infrared Coagulation (IRC)versus Sclerotherapy (SCL) 25 6.4.2 RBL versus DG-HAL versus SH versus Haemorrhoidectomy 29 6.5 Complications 31 6.5.1 Rubber Band Ligation (RBL) 31 6.5.2 Infrared Coagulation (IRC) 32 6.5.3 Sclerotherapy (SCL) 32 6.6 Relative effectiveness and ranking of the three options 32 6.7 Conclusions 33 6.8 GRADE 33 6.9 Recommendations for outpatient procedures 37 7 Surgical

2019 Palliative Care Evidence Review Service (PaCERS)

51. NOACs/DOACs: Management of Bleeding

for dabigatran is now available in Canada, while specific antidotes for the other drugs are expected to be available soon. Studies of successful reversal strategies using non-specific products in patients with bleeding have not been reported. Appropriate management in all cases of bleeding requires a systematic approach to assessing the competing risks and consequences of bleeding and thrombosis. MANAGEMENT OF BLEEDING EPISODES Minor Bleeding e.g. extremity bruising, hemorrhoid bleeding, subconjunctival (...) antiplatelet therapy. Consider higher platelet count threshold of 100 x 10 9 /L in patients with bleeding into a critical site (e.g. intracranial hemorrhage). ? Plasma and/or cryoprecipitate transfusion only if concomitant coagulopathy (e.g. massive transfusion, disseminated intravascular coagulation, liver disease). Reversal for severe/life-threatening bleeding (see Table 2) Recommended coagulation test assays and thresholds for clinically relevant plasma DOAC concentrations are estimates based

2017 Thrombosis Interest Group of Canada

52. Hypofractionated Radiation Therapy for Localized Prostate Cancer

(criterion removed July 1, 2009). Of note, 11% of participants had diabetes, 40% hypertension, 4% inflammatory bowel disease, 8% previous pelvic surgery, 7% symptomatic hemorrhoids, and 8% prior TURP. In prespecified subgroup analyses, older men (age >69 years) had a reduced biochemical or clinical failure rate with 6000 cGy in 300 cGy fractions compared to 7400 cGy in 200 cGy fractions (Hazard ratio [HR] 0.59; 90% CI: 0.43-0.81), but younger men (age ≤69 years) showed no difference between treatment

2018 American Urological Association

53. Hypofractionated Radiation Therapy for Localized Prostate Cancer

age was 69 years (range 44-85 years). Men with World Health Organization (WHO) performance status of 0 or 1 were eligible. Additional exclusion criteria included life expectancy of < 10 years, comorbid conditions precluding radical EBRT, bilateral hip prosthesis, and full anticoagulation treatment (criterion removed July 1, 2009). Of note, 11% of participants had diabetes, 40% hypertension, 4% inflammatory bowel disease, 8% previous pelvic surgery, 7% symptomatic hemorrhoids, and 8% prior TURP (...) coagulation for radiation proctitis in patients receiving conventionally fractionated EBRT (compared to those receiving ultrahypofractionation). Table 4. Toxicity and Quality of Life From the 2016 Presentation of HYPO-RT-PC RCT (KQ3) Table 4.Toxicity and Quality of Life From the 2016 Presentation of HYPO-RT-PC RCT (KQ3)55 Key Question 4 In patients with localized prostate cancer who are candidates for EBRT, how do ultrahypofractionated EBRT regimens used in clinical trials compare in terms of prostate

2018 American Society of Clinical Oncology Guidelines

54. CRACKCast E177 – Acute Complications of Pregnancy

% of women will have no pain or vaginal bleeding. Assessment is generally based on clinical features, coagulation parameters, and signs of fetal distress. Hypertension in Pregnancy Gestational hypertension occurs during pregnancy (>20wks), resolves during the postpartum period and equals a new blood pressure reading of 140/90 mm Hg or higher. Preeclampsia is gestational hypertension with proteinuria (>300 mg/24 hr); eclampsia is the occurrence of seizures in the patient with signs of preeclampsia (...) labour Occult marginal placental separations Cervical or vaginal lesions Lower genital tract lesions Hemorrhoids Bleeding during the second trimester before the fetus is potentially viable (14–24 weeks) is not benign. One-third of fetuses are ultimately lost when maternal bleeding occurs. 10) List 6 RFs for placental abruption. Differentiate clinically between a placental abruption and a placenta previa. Risk factors for placental abruption: Trauma Don’t forget to screen for domestic abuse Non

2018 CandiEM

55. New/Novel Oral Anticoagulants (NOACs): Management of Bleeding

anticoagulants, bleeding is the major complication of therapy. Specific antidotes for these drugs are expected to be available soon. Studies of successful reversal strategies using non-specific products in patients with bleeding have not been reported. Appropriate management in all cases of bleeding requires a systematic approach to assessing the competing risks and consequences of bleeding and thrombosis. MANAGEMENT OF BLEEDING EPISODES Minor Bleeding e.g. anterior epistaxis, hemorrhoid bleeding (...) . intracranial hemorrhage). ? Plasma and/or cryoprecipitate transfusion only if concomitant coagulopathy (e.g. massive transfusion, disseminated intravascular coagulation, liver disease). Reversal for severe/life-threatening bleeding (see Table 2) Recommended coagulation test assays and thresholds for clinically relevant plasma NOAC concentrations are estimates based on available evidence that require further study/validation. Dabigatran ? If dabigatran level 30 ng/mL = likely significant anticoagulant

2016 Thrombosis Interest Group of Canada

56. Management of bleeding in the late preterm period

Possible etiologies of late preterm third-trimester bleeding Obstetric Nonobstetric Placenta previa Internal or external hemorrhoids Placental accreta, increta, or percreta Urinary tract infection Placental abruption Bladder or kidney stones Vasa previa Lower gastrointestinal bleeding Early labor Lower genital tract lesions SMFM. Management of bleeding in the late preterm period. Am J Obstet Gynecol 2018 . Etiologies of late preterm bleeding Placenta previa Placenta previa can cause late preterm third (...) coagulation factors, and fibrinogen. Blood urea nitrogen, creatinine, and electrolytes may also be assessed if the likelihood for transfusion is high. A wall clot is a useful test to assess coagulopathy with acute bleeding. To perform this test, blood is placed into a plain (red-top) tube and put aside. The blood should clot within 6 minutes, and delayed clotting beyond this time is suggestive of coagulopathy. x 50 Hull AD. in: R.K.R.R. Creasy, J.D. Iams, C.J. Lockwood, T.R. Moore, M.F. Greene (Eds

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2017 Society for Maternal-Fetal Medicine

57. Commissioning guide for rectal bleeding

5.2 Other recommendations 20 5.3 Evidence base…………. 20 5.4 Guide development group for rectal bleeding 23 5.5 Funding statement………….. 23 5.6 Conflict of Interest Statement 24 Commissioning guide 2017 Rectal Bleeding 2 Glossary Term Definition anal cancer cancer arising from the anus (distinct from rectal cancer) angiodysplasia small vascular malformation of the gut which may cause profuse rectal bleeding argon plasma coagulation (APC) endoscopic procedure used to control bleeding (...) of the abdomen to exclude abdominal mass and digital rectal examination (DRE) to examine for fissure and exclude anal or rectal cancer may be useful. DRE may be deferred to second presentation in patients with a good history for hemorrhoids in low risk groups, eg young patients or those with short duration of symptoms and/or in whom review is planned. If onward referral is planned based on initial presentation, then DRE is desirable but may not be necessary. If the patient is staying in primary care, good

2018 Association of Coloproctology of Great Britain and Ireland

59. The Prevention and Treatment of the More Common Complications Related to Prostate Biopsy Update

clot retention with need for urethral catheterization and hospital admission can occur in up to 0.4 percent of patients post-biopsy. 76 Nonetheless, hematuria is rarely problematic for patients. 88 Larger prostate volume as well as increased transition zone size, 89 but not the number of biopsy cores, 90,91 are reproducibly associated with hematuria. Rectal bleeding The rectal mucosa receives a rich vascular supply from the inferior and middle rectal arteries, and patients with hemorrhoids (...) of hemostatic agents, or direct vessel ligation. 98,99 If excessive rectal bleeding is encountered, consultation with general surgery, interventional radiology, and/or gastroenterology may be necessary. Large-volume hematuria requiring intervention is similarly uncommon, and these rare occurrences can be initially managed with urethral catheter insertion, clot irrigation, and external traction for a compressive effect. Refractory cases may require cystoscopy and coagulation. III. Urinary Obstruction

2016 American Urological Association

60. Heparin-like Effect Associated With Risk of Bleeding, Sepsis, and Death in Patients With Severe Alcohol-Associated Hepatitis. (PubMed)

Heparin-like Effect Associated With Risk of Bleeding, Sepsis, and Death in Patients With Severe Alcohol-Associated Hepatitis. Endogenous heparinoids or heparin-like effects (HLEs) can cause coagulation failure in patients with cirrhosis and sepsis. We performed a prospective study of the association between HLE and bleeding events, sepsis, and outcomes of patients with severe alcohol-associated hepatitis.Our final analysis comprised 78 patients with severe alcohol-associated hepatitis (44.3 (...) ± 11.7 years; all male; discriminant function >32) who presented without sepsis at a single center in India from August 2015 through August 2016. Blood samples were collected at days 0, 3, and 7 after presentation and assessed by a global coagulation assay; by SONOCLOT (global and heparinase treated); and in assays for factor VIII, von Willebrand factor, protein C, and antithrombin. Patients were followed for sepsis, bleeding and outcome. The primary outcome was association of HLE with survival 28

2019 Clinical Gastroenterology and Hepatology

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