Annals of Coloproctology

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Anorectal benign disease

Patient-reported outcomes after hemorrhoid surgery: early results from a prospective, nationwide, real-world, cohort study on diverse approaches: Metin Kement, Atıf Tekin, Hakan Baysal, Salih Tosun, Orhan Alimoğlu, İlker Sücüllü, Osman Civil, Nevin Sakoğlu, Naciye Çiğdem Arslan, Cihad Tatar, Ali Emre Naycı, Aziz Arı, Ensar Çakır, Rozan Kaya, İlknur Turan, Taygun Gülşen, Serhat Meriç, Erkan Yavuz, Nihat Buğdaycı, Farid Mohamad Hamad, Sezai Leventoğlu, Ramazan Kozan, Özkan Akpınar, Hakan Yanar, Fatih Yanar, Hasan Fehmi Küçük, Mehmet Karahan, Selçuk Kaya, Nail Can Adıgüzel, Tolga Önder, İlker Abcı, Ahmet Zeki Aydın, Ömer Faruk Özkan, Nurhilal Kızıltoprak, Berkay Özcan, Anıl Orhan, Alp Ömer Cantürk, Murat Tan, Yusuf Bilgin, Harun Çok, Azamet Cezit, Mehmet Mahir Fersahoğlu, Mustafa Öncel; Ann Coloproctol. 2025;41(6):573-585. Published online December 30, 2025; DOI: https://doi.org/10.3393/ac.2025.00710.0101

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Abstract PDF Supplementary Material: Purpose
Real-world evidence comparing surgical techniques for symptomatic hemorrhoidal disease (HD) remains limited, despite the availability of multiple approaches. This study aimed to evaluate short-term, interim outcomes from a prospective, nationwide cohort study that compared the effectiveness of different operative techniques based on patient-reported outcome measures (PROMs) in patients with symptomatic HD.
Methods
A prospective, nationwide cohort study was conducted at 20 tertiary care centers across Turkiye between July 2022 and July 2024. Adult patients aged 18 years or older with symptomatic HD (grades I–IV) who underwent surgery during this period were included. The choice of procedure was determined by the operating surgeon, and patients were categorized into excisional, fixative, and ablative groups according to the surgical approach used. The primary outcomes were changes in the Hemorrhoidal Disease Symptom Score, Short Health ScaleHD, visual analog scale for pain, and patient satisfaction, assessed from the preoperative period to postoperative day 7 and postoperative week 6.
Results
The study included a total of 315 patients after excluding those who did not fulfil the inclusion criteria. Among them, 239 (78.9%) were male, with a mean age of 43.7±11.7 years. The distribution of patients across surgical groups was 207 (65.7%) in the excisional group, 30 (9.5%) in the fixative group, and 78 (24.8%) in the ablative group. All groups demonstrated significant improvements in PROM scores from preoperative to postoperative assessments. However, no statistically significant differences were observed between groups at any time point for PROM scores or for changes in PROM scores across consecutive evaluations (P≥0.05 for all comparisons). Urinary retention occurred more frequently, and hospital stays were longer in the fixative group (P=0.006 and P<0.001, respectively). The excisional group had a greater need for narcotic use and longer duration of use (P=0.003 and P<0.001, respectively).
Conclusion
This real-world cohort study shows that all 3 surgical approaches are effective for HD, providing comparable short-term symptomatic relief and patient satisfaction. These techniques appear equally valid treatment options, and the choice of procedure may best be individualized based on patient-specific characteristics and surgeon preference. Trial registration: ClinicalTrials.gov identifier: NCT05429060

Anorectal benign disease

Radical surgical management of perianal giant condyloma acuminatum of Buschke and Löwenstein: long-term results of 11 cases: Alp Yildiz, Sezai Leventoglu, Aybala Yildiz, Arda Inan, Bedrettin Bulent Mentes; Ann Coloproctol. 2023;39(3):204-209. Published online August 23, 2021; DOI: https://doi.org/10.3393/ac.2021.00080.0011

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Abstract PDF

Purpose
Perianal Buschke-Löwenstein tumor (BLT) is characterized by an exophytic cauliflower-like mass surrounding the perianal region. Its tendency to infiltrate the adjacent tissues, its massiveness, and its high recurrence rate cause difficulties in treatment. The aim of this study is to report our strategy with wide local excision and flap reconstruction for BLT.
Methods
From November 2002 to June 2019, 11 patients (9 men) with a mean age of 33.45 years (range, 19–54 years) were operated on for BLT. All patients underwent wide local excision and V-Y flap reconstruction, supplemented with other flaps whenever needed. No additional modalities were used.
Results
Two patients had a history of anal intercourse while all patients were human immunodeficiency virus-negative. The mean tumor length was 15.54 ± 1.34 cm (range, 10–26 cm). Human papillomavirus 6 was the most common type identified. Partial wound dehiscence developed in 3 patients, while anal stenosis, mucosal ectropion, or local recurrence was not observed during the mean follow-up period of 50.45 ± 1.75 months (range, 10–196 months).
Conclusion
In patients with perianal BLT, wide local excision and flap reconstruction result in a high healing rate without significant complications.

Citations

Citations to this article as recorded by

Unmasking the Giant Condyloma: A Case Report and Literature Review of Buschke-Löwenstein Tumor
Vasileios Tzikoulis, Anastasios Anastasiadis, Dimitrios Memmos, Stavros Tsiakaras, Ioannis Mykoniatis, Fotios Dimitriadis, Konstantinos Papathanasiou, Christos Roidos, Loukas Charalambous, Georgios Gousis, Nikolaos Tserkezis, Maria Kougioni, Dimitrios Oik
Cureus.2025;[Epub] CrossRef
An Anal Lesion in a 27-Year-Old Patient
Jérémy Baude, Hugues Mura, Alexis Lépinoy
JAMA Oncology.2024; 10(10): 1437. CrossRef
Clinicopathological Findings and Comprehensive Review of Buschke–Lowenstein Tumors Based on a Case Study
Andreea Grosu-Bularda, Cristian-Sorin Hariga, Catalina-Stefania Dumitru, Nicolae Calcaianu, Cosmin-Antoniu Creanga, Valentin Enache, Silvia-Elena Tache, Eliza-Maria Bordeanu-Diaconescu, Vladut-Alin Ratoiu, Razvan-Nicolae Teodoreanu, Ioan Lascar
Journal of Personalized Medicine.2024; 14(8): 887. CrossRef
Cirugía más inmunoterapia local en el tratamiento del tumor de Buschke-Löwenstein. A propósito de un caso
Nicole Emily Rojas Espinoza, Juan Pablo Torrico Vilte
Revista de Investigación e Información en Salud.2023; 18(44): 51. CrossRef
Surgical Management of Perianal Giant Condyloma Acuminatum of Buschke and Löwenstein: Case Presentation
Raul Mihailov, Alin Laurențiu Tatu, Elena Niculet, Iulia Olaru, Corina Manole, Florin Olaru, Oana Mariana Mihailov, Mădălin Guliciuc, Adrian Beznea, Camelia Bușilă, Iuliana Laura Candussi, Lavinia Alexandra Moroianu, Floris Cristian Stănculea
Life.2023; 13(9): 1916. CrossRef

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