Efficacy and safety of Lingnan surgery for the treatment of multi-quadrant acute incarcerated hemorrhoids: A retrospective study.

OBJECTIVE: In this study, we introduce a surgical procedure for multiple-quadrant hemorrhoid crisis, namely Lingnan surgery, and discuss its clinical efficacy and safety. METHODS: We performed a retrospective analysis of patients with acute incarcerated hemorrhoids who underwent Lingnan surgery at the Anorectal Department of Yunan County Hospital of Traditional Chinese Medicine of Guangdong Province from 2017 to 2021. The baseline data, preoperative condition, and postoperative condition of each patient were recorded in detail. RESULTS: A total of 44 patients were studied. There were no cases of massive hemorrhage, wound infection, wound nonunion, anal stenosis, abnormal anal defecation, recurrent anal fissure, or mucosal eversion within 30 days after surgery, and no recurrence of hemorrhoids and anal dysfunction occurred during the 6-month follow-up after surgery. The average operation time was 26.5 ± 6.2 min (17-43 min). The average length of hospital stay was 4.0 ± 1.2 days (2-7 days). In terms of postoperative analgesia, 35 patients took oral nimesulide, 6 did not use any analgesics, and 3 required nimesulide plus tramadol by injection. The mean Visual Analog Scale pain score was 6.8 ± 0.8 preoperatively and 2.9 ± 1.2, 2.0 ± 0.7, and 1.4 ± 0.6 at 1, 3, and 5 days postoperatively, respectively. The average basic activities of daily living score was 98.2 ± 2.6 (90-100) at discharge. CONCLUSION: Lingnan surgery is easy to perform and has obvious curative effects, providing an alternative to conventional procedures for acute incarcerated hemorrhoids.

A retrospective analysis of ultralow anterior resection vs. abdomino-perineal resection for lower rectal cancer.

BACKGROUND/AIMS: The aim of this study was to compare the oncological outcome of ultralow anterior resection (ULAR) and abdominoperineal resection (APR) for lower rectal cancer. METHODOLOGY: Medical records of 276 patients with lower rectal cancer of whom 140 underwent ULAR and 136 underwent APR were included in a retrospective comparative study. Clinicopathological parameters, overall survival and tumor relapse and prognostic factors were analyzed retrospectively. RESULTS: There was no postoperative mortality in either group. Medical and surgical morbidity, especially pelvic abscess formation were similar in the two groups. The operation time was longer in the APR group (p<0.001). The hospital stay was shorter in the ULAR group (p=0.003). The 5 year overall and disease-free survival rates were 60.5% and 51.1%. There was no difference of overall and disease-free survival (p>0.05), between ULAR and APR surgery at 5 years. Patients who underwent ULAR showed more total recurrence (34.3% vs. 22.1%, p=0.031) and more local recurrence (20.7% vs. 8.8%, p=0.01) but showed no difference in distant recurrence (13.6% vs. 13.2%, p=0.92). CONCLUSIONS: Ultralow anterior resection and abdominoperineal resection have similar long-term outcome in lower rectal cancer. In tumor local relapse, APR is more effective than ULAR, but in distant metastasis, it not better than ULAR.