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Ten-year multicentric retrospective analysis regarding postoperative complications and impact of comorbidities in hemorrhoidal surgery with literature review

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World Journal of Clinical Cases 2023年第2期11卷 366-384页

作者： Cosmin Moldovan elena rusu Daniel Cochior Madalina elena Toba Horia Mocanu Razvan Adam Mirela Rimbu Adrian Ghenea Florin Savulescu Daniela Godoroja Florin Botea Department of Medical Surgical Disciplines Faculty of MedicineTitu Maiorescu University of BucharestBucharest 031593Romania Department of General Surgery Witting Clinical HospitalBucharest 010243Romania Department of Preclinic Disciplines Faculty of MedicineTitu Maiorescu University of BucharestBucharest 031593Romania Department of General Surgery Sanador Clinical HospitalBucharest 010991Romania Department of General Surgery Monza Clinical HospitalBucharest 021967Romania Department of Ear Nose and ThroatIlfov County Clinical Emergency HospitalBucharest 022104Romania Department of Orthopedics and Traumatology Elias Emergency University HospitalBucharest 011461Romania Medical Doctoral School Titu Maiorescu University of BucharestBucharest 040317Romania Department of Coloproctology MedLife SA Băneasa HyperclinicBucharest 013693Romania nd Department of Surgery Carol Davila Central Military Emergency University HospitalBucharest 010242Romania Department of Anesthesia Ponderas Academic HospitalBucharest 014142Romania Florin Botea 2nd Department of SurgeryFundeni Clinical InstituteBucharest 022328Romania

BACKGROUND Hemorrhoidal disease(HD)is considered a low-severity pathology by both general population and physicians,but the lengthy conservative therapy and postoperative complications suggest *** To assess the effectiveness of different treatment options,both conservative and surgical,in contrast with some preexisting *** We conducted a retrospective,10-yearlong study between January 2011 and December 2021 in two surgical centers,a private and a state-owned *** compared the efficacy and safety of several treatment options,such as open hemorrhoidectomy,stapled hemorrhoidopexy,rubber band ligation and infrared coagulation in terms of complication rates and types and their correlation with different preexisting comorbidities such as inflammatory bowel disease(IBD),use of anticoagulant medication(AM)and liver *** also conducted a 20-years long PubMed research(1.263 articles)for relevant *** Our study recorded 10940 patients with HD,10241 with conservative and 699 with surgical *** of these,the male-to-female ratio of 1.3,and a peak in age distribution between 59 and 68 years old(32%of patients).For the entire study,we recorded a 90%incidence of immediate pain,immediate bleeding in 1.5%(11 cases),delayed bleeding in 1.0%(7 cases),and 0.6%surgical site *** retention was also present,with 0.2%of patients,anal stricture in 1%and fecal incontinence for 0.5%of patients(4 cases).We recorded no severe complications such as Fournier`s gangrene or rectovaginal *** accounted for 6%of the patients,with ulcerative colitis in 12%and Chron`s disease in 10.5%.6.6%of the patients had AM,determining 4%immediate and 2%delayed bleeding,in surgically treated *** Our study determined that most common complications(pain,urinary retention,bleeding,and stricture)are correlated with each surgical technique and pre-existing comorbidities.

关键词： Retrospective Hemorrhoidal Postoperative Complications Comorbidities

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Accessory renal arteries-a source of hypertension:A case report

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World Journal of Clinical Cases 2023年第7期11卷 1506-1512页

作者： Amalia Calinoiu elena-Cristina Guluta Adina rusu Alexandra Minca Dragos Minca Luminita Tomescu Valeriu Gheorghita Dana Galieta Minca Lucian Negreanu Department of Internal Medicine Prof.Dr.Agrippa Ionescu Emergency Clinical HospitalBucuresti 011356BucureștiRomania Department of Gastroenterology Bucharest University Emergency HospitalBucharest 050098Romania Department of Internal Medicine Clinic Bucharest University Emergency HospitalBucharest 050098Romania Department of Rheumatology Clinic Center of Rheumatic Disease"Dr.Ion Stoia"Bucharest 030167Romania Department of Radiology Clinic Prof.Dr.Agrippa Ionescu Clinical Emergency HospitalBucharest 011356Romania Department of Infectious Disease Clinic Prof Dr.Agrippa Ionescu Clinical Emergency HospitalBucharest 011356Romania Department of Public Health and Management Carol Davila University of Medicine and PharmacyBucharest 020021Romania Department of Gastroenterology Carol Davila University of Medicine and PharmacyBucharest 020021Romania

BACKGROUND Secondary hypertension is a relatively rare condition most commonly caused by renovascular disease due to atherosclerotic vascular disease or fibromuscular *** accessory renal arteries are frequent,to date,only six cases of secondary hypertension determined by their existence have been *** SUMMARY We describe a case of a 39-year-old female who came to the emergency department with an urgent hypertensive crisis and hypertensive *** normal renal arteries,the computed tomography angiography revealed an inferior polar artery with 50%stenosis of its *** treatment with amlodipine,indapamide and perindopril was adopted,leading to blood pressure control within one *** To the best of our knowledge,there are controversies regarding accessory renal arteries as a potential etiology for secondary hypertension,but the seven similar cases already described,along with the current case,could reinforce the necessity of more studies concerning this subject.

关键词： Accessory artery Secondary hypertension Renal artery stenosis Renovascular disease Risk factor Young patients Case report

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