Annals of Coloproctology

Original Articles

Benign proctology

Prospective Comparative Analysis of the Incidence of Vasovagal Reaction and the Effect of Rectal Submucosal Lidocaine Injection in Stapled Hemorrhoidopexy: A Randomized Controlled Trial: Kyung Jin Cho, Do Yeon Hwang, Hyun Joo Lee, Ki Hoon Hyun, Tae Jung Kim, Duk Hoon Park; Ann Coloproctol. 2020;36(5):344-348. Published online March 16, 2020; DOI: https://doi.org/10.3393/ac.2020.02.12

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Purpose
This study was performed to evaluate the incidence of vasovagal reactions (VVRs) and the efficacy of lidocaine injection for prevention.
Methods
One hundred seventeen patients diagnosed with hemorrhoids and scheduled to undergo a stapled hemorrhoidopexy (SH) were randomly divided according to submucosal injection to the rectum: lidocaine group (n = 53, lidocaine injected just before full closure of the stapler) and control group (n = 58). Outcomes included baseline patient characteristics (American Society of Anesthesiologists physical status classification, body mass index, diabetes mellitus, hypertension, and previous VVR history), vital signs during the operation, incidence of VVRs (hypotension, bradycardia, dizziness, diaphoresis, and nausea/vomiting), and postoperative complications (pain, bleeding, and urinary retention).
Results
Baseline characteristics were similar between groups. The number of patients with lower abdominal pain after firing the stapler and incidence of dizziness were lower for the lidocaine group than for the control group (9.4% vs. 25.9%, P = 0.017; 0% vs. 8.6%, P = 0.035, respectively). However, there were no significant between-group differences in incidence of nausea and diaphoresis (0% vs. 3.4%, P = 0.172) and syncope (1.9% vs. 3.4%, P = 0.612). Fewer patients in the lidocaine group complained of postoperative pain (41.5% vs. 58.6%, P = 0.072), and these patients used analgesics less frequently than those in the control group (28.3% vs. 36.2%, P = 0.374).
Conclusion
Patients who received a submucosal lidocaine injection prior to SH experienced less lower abdominal pain and dizziness compared with those who received standard treatment. A larger, more detailed prospective study is needed for further analysis.

Citations

Citations to this article as recorded by

Reducing Pain, Spasm, and Vasovagal Syndrome in Transradial Cardiac Angiography: The Role of Lidocaine Cream and Injectable Lidocaine
Behrang Bahreini, Saeed Alipour Parsa, Vahid Eslami, Mohammad Khani, Abdolhamid Bagheri
International Journal of Cardiovascular Practice.2024;[Epub] CrossRef
PROSPECT guideline for haemorrhoid surgery
Alexis Bikfalvi, Charlotte Faes, Stephan M. Freys, Girish P. Joshi, Marc Van de Velde, Eric Albrecht
European Journal of Anaesthesiology Intensive Care.2023; 2(3): e0023. CrossRef
Treatment of Hemorrhoid in Unusual Condition-Pregnancy
Hyo Seon Ryu
The Ewha Medical Journal.2022;[Epub] CrossRef
The Effort to Reduce Vasovagal Reaction and Abdominal Pain During Stapled Hemorrhoidopexy
Hyeonseok Jeong
Annals of Coloproctology.2020; 36(5): 291. CrossRef

Is Conservative Treatment with Antibiotics the Correct Strategy for Management of Right Colonic Diverticulitis?: A Prospective Study: Tae Jung Kim, In Kyu Lee, Jong Kyung Park, Yoon Suk Lee, Youn Si, Hun Jung, Hyung Jin Kim, Sang Chul Lee, Dae Young Cheung, Lee D. Gorden, Seung Taek Oh; J Korean Soc Coloproctol. 2011;27(4):188-193. Published online August 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.4.188

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41 Download
13 Citations

Abstract PDF

Purpose

The goals of this study were to identify whether conservative treatment with antibiotics in right colonic diverticulitis (RCD) patients, our empirical method used until now, is adequate and to determine how the natural history of RCD is affected by conservative treatment.

Methods

This study was designed as a case-control study. Group I was comprised of 12 patients who were managed conservatively, and clinical data were retrospectively collected. In group II, a total of 49 patients, diagnosed by using diagnostic criteria for RCD and managed conservatively, were prospectively included.

Results

The period of fasting was 2.7 days, and the hospital stay was 4.6 days in all patients. The intravenous and the oral antibiotic periods were 3.8 days and 9.8 days, respectively. There were no statistically significant differences in treatment results between the two groups except the duration of fasting and the hospitalization, and there were no complications under conservative treatment. Eight patients (13.1%) had recurrent diverticulitis during the follow-up period. The recurrence risk showed no significant difference between the groups. The RCD-free period after management was 60.1 months, and patients with recurrent RCD were treated by conservative treatment or laparoscopic surgery.

Conclusion

Conservative treatment with antibiotics is the optimal treatment of choice for RCD and shows no increase in complications.

Citations

Citations to this article as recorded by

Unusual Variations and Atypical Presentations of Diverticulitis
Sarah Kling, Simran Kripalani, Joceline V. Vu
Clinics in Colon and Rectal Surgery.2024;[Epub] CrossRef
The outcomes of right-sided and left-sided colonic diverticulitis following non-operative management: a systematic review and meta-analysis
Sih-Shiang Huang, Chih-Wei Sung, Hsiu-Po Wang, Wan-Ching Lien
World Journal of Emergency Surgery.2022;[Epub] CrossRef
Caecal diverticulitis can be misdiagnosed as acute appendicitis: a systematic review of the literature
Isabelle Uhe, Jeremy Meyer, Manuela Viviano, Surrennaidoo Naiken, Christian Toso, Frédéric Ris, Nicolas C. Buchs
Colorectal Disease.2021; 23(10): 2515. CrossRef
Laparoscopic diverticulectomy versus non-operative treatment for uncomplicated right colonic diverticulitis
Le Huy Luu, Nguyen Lam Vuong, Vo Thi Hong Yen, Do Thi Thu Phuong, Bui Khac Vu, Nguyen Viet Thanh, Nguyen Thien Khanh, Nguyen Van Hai
Surgical Endoscopy.2020; 34(5): 2019. CrossRef
Recurrence of Acute Right Colon Diverticulitis Following Nonoperative Management: A Systematic Review and Meta-analysis
Yongjin F. Lee, Dalun D. Tang, Samik H. Patel, Michael A. Battaglia, Beth-Ann Shanker, Robert K. Cleary
Diseases of the Colon & Rectum.2020; 63(10): 1466. CrossRef
Reste-t-il des indications pour la chirurgie à froid ?
B. Schiltz, C. Dumont, N. C. Buchs, Ph. Morel, F. Ris
Côlon & Rectum.2017; 11(1): 25. CrossRef
Right colonic diverticulitis in Caucasians: presentation and outcomes versus left-sided disease
Laura Valbousquet Schneider, Ingrid Millet, Isabelle Boulay-Coletta, Patrice Taourel, Jérôme Loriau, Marc Zins
Abdominal Radiology.2017; 42(3): 810. CrossRef
Diagnóstico y tratamiento de la enfermedad diverticular del colon derecho: revisión de conjunto
Francesco Ferrara, Jesús Bollo, Letizia V Vanni, Eduardo M Targarona
Cirugía Española.2016; 94(10): 553. CrossRef
Diagnosis and Management of Right Colonic Diverticular Disease: A Review
Francesco Ferrara, Jesús Bollo, Letizia V. Vanni, Eduardo M. Targarona
Cirugía Española (English Edition).2016; 94(10): 553. CrossRef
Risk factors for recurrence of right colonic uncomplicated diverticulitis after first attack
Hyoung-Chul Park, Byung Seup Kim, Kwanseop Lee, Min Jeong Kim, Bong Hwa Lee
International Journal of Colorectal Disease.2014; 29(10): 1217. CrossRef
Solitary Cecal Diverticulitis: An Unusual Cause of Acute Right Iliac Fossa Pain—A Case Report and Review of the Literature
Nikolaos Mudatsakis, Marinos Nikolaou, Konstantinos Krithinakis, Michail Matalliotakis, Nikolaos Politis, Emmanouil Andreadakis
Case Reports in Surgery.2014; 2014: 1. CrossRef
Prediction and management of recurrent right colon diverticulitis
Sun Min Park, Taek Soo Kwon, Dong Jin Kim, Yoon Suk Lee, Dae Young Cheung, Seong Taek Oh, Jun-Gi Kim, In Kyu Lee
International Journal of Colorectal Disease.2014; 29(11): 1355. CrossRef
Mesalamine Did Not Prevent Recurrent Diverticulitis in Phase 3 Controlled Trials
Jeffrey B. Raskin, Michael A. Kamm, M. Mazen Jamal, Juan Márquez, Ehud Melzer, Robert E. Schoen, Tibor Szalóki, Karen Barrett, Paul Streck
Gastroenterology.2014; 147(4): 793. CrossRef

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