The development of a patient reported outcome measure and imaging modalities in the evaluation of haemorrhoidal disease

With the advent of DGHAL and PPH, treatments that purport to work by disrupting the arterial supply of haemorrhoids, there has been resurgence in interest in the vascular theory of pathogenesis of haemorrhoids. Despite uncertainty surrounding recurrence and complication rates there has been signific...

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Main Author: Parsons, Caron Saeko
Format: Thesis (University of Nottingham only)
Language:English
Published: 2012
Subjects:
Online Access:https://eprints.nottingham.ac.uk/28466/
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author Parsons, Caron Saeko
author_facet Parsons, Caron Saeko
author_sort Parsons, Caron Saeko
building Nottingham Research Data Repository
collection Online Access
description With the advent of DGHAL and PPH, treatments that purport to work by disrupting the arterial supply of haemorrhoids, there has been resurgence in interest in the vascular theory of pathogenesis of haemorrhoids. Despite uncertainty surrounding recurrence and complication rates there has been significant uptake of the new surgical approach due to decreased post-operative pain. However this has not been matched by discussion or evaluation of how haemorrhoidal disease and successful outcome should be evaluated. This thesis evaluates different approaches to the measurement of the burden of haemorrhoidal disease to the patient. A patient reported outcome measure was designed, administered and evaluated by the investigator. Reliability, reproducibility, validity, responsiveness and acceptability have been demonstrated. Three-dimensional ultrasound was used to acquire volumetric data and power Doppler angiography from the anal canal, which was shown to be reliable. Measures of power Doppler angiography were shown to be significantly lower in healthy volunteers than in patients. This technique represents promising value as an outcome measure of haemorrhoidal disease. A dual isotope-surgical nuclear probe technique attempted to measure change in volume of haemorrhoids following rubber band ligation, however consistent results were not obtained. Magnetic resonance imaging was able to demonstrate anal cushions and haemorrhoids, and the feasibility of this method has been demonstrated.
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spelling nottingham-284662025-02-28T11:33:45Z https://eprints.nottingham.ac.uk/28466/ The development of a patient reported outcome measure and imaging modalities in the evaluation of haemorrhoidal disease Parsons, Caron Saeko With the advent of DGHAL and PPH, treatments that purport to work by disrupting the arterial supply of haemorrhoids, there has been resurgence in interest in the vascular theory of pathogenesis of haemorrhoids. Despite uncertainty surrounding recurrence and complication rates there has been significant uptake of the new surgical approach due to decreased post-operative pain. However this has not been matched by discussion or evaluation of how haemorrhoidal disease and successful outcome should be evaluated. This thesis evaluates different approaches to the measurement of the burden of haemorrhoidal disease to the patient. A patient reported outcome measure was designed, administered and evaluated by the investigator. Reliability, reproducibility, validity, responsiveness and acceptability have been demonstrated. Three-dimensional ultrasound was used to acquire volumetric data and power Doppler angiography from the anal canal, which was shown to be reliable. Measures of power Doppler angiography were shown to be significantly lower in healthy volunteers than in patients. This technique represents promising value as an outcome measure of haemorrhoidal disease. A dual isotope-surgical nuclear probe technique attempted to measure change in volume of haemorrhoids following rubber band ligation, however consistent results were not obtained. Magnetic resonance imaging was able to demonstrate anal cushions and haemorrhoids, and the feasibility of this method has been demonstrated. 2012-07-16 Thesis (University of Nottingham only) NonPeerReviewed application/pdf en arr https://eprints.nottingham.ac.uk/28466/1/580294.pdf Parsons, Caron Saeko (2012) The development of a patient reported outcome measure and imaging modalities in the evaluation of haemorrhoidal disease. PhD thesis, University of Nottingham. Pathogenesis of haemorrhoids Outcome evaluation Three-dimensional ultrasound Magnetic resonance imaging
spellingShingle Pathogenesis of haemorrhoids
Outcome evaluation
Three-dimensional ultrasound
Magnetic resonance imaging
Parsons, Caron Saeko
The development of a patient reported outcome measure and imaging modalities in the evaluation of haemorrhoidal disease
title The development of a patient reported outcome measure and imaging modalities in the evaluation of haemorrhoidal disease
title_full The development of a patient reported outcome measure and imaging modalities in the evaluation of haemorrhoidal disease
title_fullStr The development of a patient reported outcome measure and imaging modalities in the evaluation of haemorrhoidal disease
title_full_unstemmed The development of a patient reported outcome measure and imaging modalities in the evaluation of haemorrhoidal disease
title_short The development of a patient reported outcome measure and imaging modalities in the evaluation of haemorrhoidal disease
title_sort development of a patient reported outcome measure and imaging modalities in the evaluation of haemorrhoidal disease
topic Pathogenesis of haemorrhoids
Outcome evaluation
Three-dimensional ultrasound
Magnetic resonance imaging
url https://eprints.nottingham.ac.uk/28466/