Role of antibiotics in Milligan-Morgan hemorrhoidectomy for Grade III to IV Hemorrhoids: A randomized clinical trial.

PURPOSE: This study was mainly to compare the safety and long-term clinical efficacy of using intravenous antibiotics in Milligan Morgan hemorrhoidectomy for Grade III to IV Prolapsing Hemorrhoids. METHODS: This was a parallel group, 3-arm, randomized clinical trial to evaluate the efficacy of intravenous prophylactic antibiotics. A total of 150 consecutive patients undergoing Milligan Morgan hemorrhoidectomy (MMH) in a tertiary hospital for grade III/IV hemorrhoids from January 2020 to August 2022 were enrolled. Patients were randomly assigned to three groups using a computer-generated table. Group A did not receive any prophylactic antibiotic, group B received 2 g I/V Cefoxitin Sodium before the induction of anesthesia, and group C received 2 g I/V Cefoxitin Sodium before the induction of anesthesia and 6 h after operation. RESULTS: There was no significant difference in measured VAS values on the 1st day,3rd day and 7th day after surgery (p> 0.05). Compared with VAS values on the 1st day postoperatively, these values got decreased on the 3rd day and 7th day after surgery (p< 0.05). In addition, there was no significant difference among the first defecation time, wound edema, bleeding, urinary retention after surgery (p> 0.05). There was no significant difference in the outcome comparison between all 3 groups' basal and the 3rd day postoperatively no matter in WBC, NUET% or CRP (p> 0.05). However, compared with basal, the WBC, NUET%,CRP(p< 0.05) of group A and group B on the 3rd day postoperatively got rised, the rate of recurrence of hemorrhoids follow-up for 1 year was 1.4%. CONCLUSIONS: Our results suggest that there is no efficacy on intravenous prophylactic antibiotics in Milligan Morgan hemorrhoidectomy.

Rectal mature teratoma: A case report.

BACKGROUND: Rectal mature teratoma is rare and has been reported as a case report in this study. Herein, clinical presentation, magnetic resonance imaging findings, and immunohistochemistry showed a pelvic rectal mature teratoma. The case report and the surgical treatment procedure have been discussed below. CASE SUMMARY: A 29-year-old Chinese female showed up with over a 1-mo history of perianal mass that emerged after defecation. Physical examination indicated that the mass was 4 cm × 3 cm × 3 cm. The intraoperative procedure involved ligation of the sigmoid colon 10 cm above the upper edge of the tumor, followed by ligation of the rectum 3.5 cm above the upper edge of the tumor, and subsequent complete removal of the mass. The histopathology confirmed the mature teratoma. CONCLUSION: The tumor can be completely removed using surgery to prevent its recurrence.

[Effect of electroacupuncture at Chengshan (BL 57) on postoperative pain of mixed hemorrhoids].

OBJECTIVE: To discuss the effect of electroacupuncture at Chengshan (BL 57) on postoperative pain of mixed hemorrhoids. METHODS: One hundred and twenty cases with postoperative pain of mixed hemorrhoids were divided into an electroacupuncture group (60 cases) and a medication group (60 cases) randomly. The disperse-dense wave in frequency of 2Hz/100Hz at Chengshan (BL 57) were used in the electroacupuncture group. Its first treatment was in 30 min after the operation, and then it was given once a day after hip bath in the morning. 2 tablets of Naproxen Sunstained Release Capsule were taken in 30 min after operation in the medication group, and then it was taken 2 tablets a day before dressing change. After 4 times of treatment, evaluate the changing condition of Visual Analogue Scale (VAS) at 5 h, 24 h, 48 h and 72 h after operation. RESULTS: The VAS at 5 h, 24 h, 48 h and 72 h after operation in the electroacupuncture group (6.78 +/- 2.12, 5.56 +/- 1.87, 4.34 +/- 2.23 and 3.15 +/- 2.11) were all lower than those in the medication group (7.56 +/- 2.01, 6.23 +/- 1.15, 5.57 +/- 2.21 and 4.34 +/- 2.12), and the difference was statistically significant (all P < 0.05). CONCLUSION: Electroacupuncture at Chengshan (BL 57) can reduce the postoperative pain of mixed hemorrhoids.