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  • Lucious Hendrix posted an update 3 days, 15 hours ago

    ConclusionColonoscopy is a safe examination when performed under conscious sedation, as even though several factors contribute to the emergence of possible complications, in this study the number of patients with complications was 0.17%, with respiratory depression. Patient age showed an inverse association, i.e., the older the patient, the lower the required dose of medication. The low rate of complications in the study demonstrated the high degree of safety of the drugs used during colonoscopy, corroborating their frequent use for superficial/conscious sedation for this procedure.Conflicts of interestThe authors declare no conflicts of interest.IntroductionHemorrhoidal disease affects a large part of the world\’s population. The prevalence in our country is not precisely documented, but in the United States it is approximately 4.4%.1 The disease is associated with the vascular Tedizolid HCl of arterial blood hyperflow, causing dilations in the hemorrhoidal plexuses and, consequently, venous hyperplasia and congestion.2In 1995, Morinaga et al. proposed a new therapeutic method based on the etiopathogenesis described above. A Doppler (Moricorn) was used in the assessment and after the arterial flow identification, a high ligature was made in these branches, reducing the blood gradient reaching the hemorrhoidal plexus.3 Based on this principle, several techniques that require anesthesia have been developed, such as mechanical anopexy4 and transanal hemorrhoidal dearterialization (THD).2,5In search for a surgical technique for hemorrhoidal disease with less postoperative pain, Salfi et al., in 2009, described the Hemorrhoidal LASER Procedure (HeLP) technique. It is a minimally-invasive technique, which does not require anesthesia, and consists in the identification of the terminal branches of the rectal artery through a Doppler located in a specially adapted proctoscope, followed by photocoagulation of entropy branches using a 980 nm LASER diode fiber.6,7This publication aims to describe the first 55 cases in which the HeLP technique was used in Brazil. A three-year follow-up was carried out, analyzing clinical and functional aspects of patients operated by the same surgical team, evaluating pre- and postoperative symptoms, characteristics of the studied population, description of the technique used, need for anesthesia for the procedure and the overall satisfaction index related to the technique.Materials and methodBetween 2011 and 2014, 55 patients were submitted to the HeLP technique, by the same surgeon, for hemorrhoidal disease grades I and II, or grade III with little mucosal prolapse. Grade IV or grade III hemorrhoids with large mucosal prolapse identified during outpatient proctologic examination were excluded from the study. Data were prospectively collected and analyzed.Before undergoing the surgical procedure, the patients were submitted to colonoscopy or rectosigmoidoscopy to exclude other possible causes of bleeding.