Purpose: The long-term outcomes and efficacy of partial stapled hemorrhoidopexy (PSH) compared with those of conventional hemorrhoidectomy (CH) are not fully understood. This study aimed to introduce a modified PSH (mPSH) and compare its clinical efficacy and safety with those of CH. Methods: A prospective randomized controlled trial was conducted. This study was performed at a single hospital and involved 6 colorectal surgeons. In total, 110 patients were enrolled between July 2019 and September 2020. Patients were randomly assigned to undergo either mPSH group (n=55) or CH group (n=55). The primary outcome was to compare postoperative average pain and postoperative peak pain using visual analog scale score between the 2 groups. Results: The required duration of analgesia was shorter in the mPSH group than in the CH group, although the difference was not statistically significant (P=0.096). However, the laxative requirement duration (P<0.010), return to work (P<0.010), satisfaction score (P<0.010), and Vaizey score (P=0.014) were significantly better in the mPSH group. The average and peak postoperative pain scores were significantly lower in the mPSH group during the 15 days after surgery (P<0.001). The overall complication rate in both groups was 9.1%, with no significant difference between the groups (P=0.867). Conclusion The mPSH group demonstrated better improvement in symptoms, lower pain scores, and greater patient early satisfaction after surgery than the CH group. Therefore, this surgical technique appears to be a safe and effective alternative for CH.

Purpose: The long-term outcomes and efficacy of partial stapled hemorrhoidopexy (PSH) compared with those of conventional hemorrhoidectomy (CH) are not fully understood. This study aimed to introduce a modified PSH (mPSH) and compare its clinical efficacy and safety with those of CH. Methods: A prospective randomized controlled trial was conducted. This study was performed at a single hospital and involved 6 colorectal surgeons. In total, 110 patients were enrolled between July 2019 and September 2020. Patients were randomly assigned to undergo either mPSH group (n=55) or CH group (n=55). The primary outcome was to compare postoperative average pain and postoperative peak pain using visual analog scale score between the 2 groups. Results: The required duration of analgesia was shorter in the mPSH group than in the CH group, although the difference was not statistically significant (P=0.096). However, the laxative requirement duration (P<0.010), return to work (P<0.010), satisfaction score (P<0.010), and Vaizey score (P=0.014) were significantly better in the mPSH group. The average and peak postoperative pain scores were significantly lower in the mPSH group during the 15 days after surgery (P<0.001). The overall complication rate in both groups was 9.1%, with no significant difference between the groups (P=0.867). Conclusion The mPSH group demonstrated better improvement in symptoms, lower pain scores, and greater patient early satisfaction after surgery than the CH group. Therefore, this surgical technique appears to be a safe and effective alternative for CH.

Purpose: The long-term outcomes and efficacy of partial stapled hemorrhoidopexy (PSH) compared with those of conventional hemorrhoidectomy (CH) are not fully understood. This study aimed to introduce a modified PSH (mPSH) and compare its clinical efficacy and safety with those of CH. Methods: A prospective randomized controlled trial was conducted. This study was performed at a single hospital and involved 6 colorectal surgeons. In total, 110 patients were enrolled between July 2019 and September 2020. Patients were randomly assigned to undergo either mPSH group (n=55) or CH group (n=55). The primary outcome was to compare postoperative average pain and postoperative peak pain using visual analog scale score between the 2 groups. Results: The required duration of analgesia was shorter in the mPSH group than in the CH group, although the difference was not statistically significant (P=0.096). However, the laxative requirement duration (P<0.010), return to work (P<0.010), satisfaction score (P<0.010), and Vaizey score (P=0.014) were significantly better in the mPSH group. The average and peak postoperative pain scores were significantly lower in the mPSH group during the 15 days after surgery (P<0.001). The overall complication rate in both groups was 9.1%, with no significant difference between the groups (P=0.867). Conclusion The mPSH group demonstrated better improvement in symptoms, lower pain scores, and greater patient early satisfaction after surgery than the CH group. Therefore, this surgical technique appears to be a safe and effective alternative for CH.

Purpose: The long-term outcomes and efficacy of partial stapled hemorrhoidopexy (PSH) compared with those of conventional hemorrhoidectomy (CH) are not fully understood. This study aimed to introduce a modified PSH (mPSH) and compare its clinical efficacy and safety with those of CH. Methods: A prospective randomized controlled trial was conducted. This study was performed at a single hospital and involved 6 colorectal surgeons. In total, 110 patients were enrolled between July 2019 and September 2020. Patients were randomly assigned to undergo either mPSH group (n=55) or CH group (n=55). The primary outcome was to compare postoperative average pain and postoperative peak pain using visual analog scale score between the 2 groups. Results: The required duration of analgesia was shorter in the mPSH group than in the CH group, although the difference was not statistically significant (P=0.096). However, the laxative requirement duration (P<0.010), return to work (P<0.010), satisfaction score (P<0.010), and Vaizey score (P=0.014) were significantly better in the mPSH group. The average and peak postoperative pain scores were significantly lower in the mPSH group during the 15 days after surgery (P<0.001). The overall complication rate in both groups was 9.1%, with no significant difference between the groups (P=0.867). Conclusion The mPSH group demonstrated better improvement in symptoms, lower pain scores, and greater patient early satisfaction after surgery than the CH group. Therefore, this surgical technique appears to be a safe and effective alternative for CH.

Purpose: The long-term outcomes and efficacy of partial stapled hemorrhoidopexy (PSH) compared with those of conventional hemorrhoidectomy (CH) are not fully understood. This study aimed to introduce a modified PSH (mPSH) and compare its clinical efficacy and safety with those of CH. Methods: A prospective randomized controlled trial was conducted. This study was performed at a single hospital and involved 6 colorectal surgeons. In total, 110 patients were enrolled between July 2019 and September 2020. Patients were randomly assigned to undergo either mPSH group (n=55) or CH group (n=55). The primary outcome was to compare postoperative average pain and postoperative peak pain using visual analog scale score between the 2 groups. Results: The required duration of analgesia was shorter in the mPSH group than in the CH group, although the difference was not statistically significant (P=0.096). However, the laxative requirement duration (P<0.010), return to work (P<0.010), satisfaction score (P<0.010), and Vaizey score (P=0.014) were significantly better in the mPSH group. The average and peak postoperative pain scores were significantly lower in the mPSH group during the 15 days after surgery (P<0.001). The overall complication rate in both groups was 9.1%, with no significant difference between the groups (P=0.867). Conclusion The mPSH group demonstrated better improvement in symptoms, lower pain scores, and greater patient early satisfaction after surgery than the CH group. Therefore, this surgical technique appears to be a safe and effective alternative for CH.

Background: Atherogenic dyslipidemia, which is frequently associated with type 2 diabetes (T2D) and insulin resistance, contributes to the development of vascular complications. Statin therapy is the primary approach to dyslipidemia management in T2D, however, the role of non-statin therapy remains unclear. Ezetimibe reduces cholesterol burden by inhibiting intestinal cholesterol absorption. Fibrates lower triglyceride levels and increase high-density lipoprotein cholesterol (HDL-C) levels via peroxisome proliferator- activated receptor alpha agonism. Therefore, when combined, these drugs effectively lower non-HDL-C levels. Despite this, few clinical trials have specifically targeted non-HDL-C, and the efficacy of triple combination therapies, including statins, ezetimibe, and fibrates, has yet to be determined. Methods: This is a multicenter, prospective, randomized, open-label, active-comparator controlled trial involving 3,958 eligible participants with T2D, cardiovascular risk factors, and elevated non-HDL-C (≥100 mg/dL). Participants, already on moderate-intensity statins, will be randomly assigned to either Ezefeno (ezetimibe/fenofibrate) addition or statin dose-escalation. The primary end point is the development of a composite of major adverse cardiovascular and diabetic microvascular events over 48 months. Conclusion This trial aims to assess whether combining statins, ezetimibe, and fenofibrate is as effective as, or possibly superior to, statin monotherapy intensification in lowering cardiovascular and microvascular disease risk for patients with T2D. This could propose a novel therapeutic approach for managing dyslipidemia in T2D.

Purpose: To analyze changes in choroidal thickness in patients with recurrent rhegmatogenous retinal detachment (RRD) before and after surgical intervention and to identify factors that influence changes in choroidal thickness. Methods: A retrospective observational study was conducted on patients who underwent surgery for recurrent RRD from November 2019 to March 2023. Choroidal thickness was measured using optical coherence tomography at baseline and at 2 and 6 months postoperatively. The study analyzed the impact of various factors on choroidal thickness changes. Results: The study included 33 patients, demonstrating a significant decrease in choroidal thickness in the surgical eye compared to the fellow eye over a 6-month period. In the univariate analysis, changes in choroidal thickness were significantly correlated with changes in central retinal thickness (p = 0.048) from baseline to 2 months and with proliferative vitreoretinopathy (PVR) grade from 2 to 6 months (p = 0.009) and from baseline to 6 months (p = 0.020). In the multivariate analysis, an association was found between changes in choroidal thickness from 2 to 6 months and PVR grade (p = 0.030) Conclusions The findings indicate that surgical reattachment in eyes with recurrent RRD leads to a significant reduction in choroidal thickness. The extent of this reduction is influenced by the severity of PVR, highlighting the importance of considering PVR severity when evaluating surgical outcomes in patients with recurrent RRD.

Purpose: To analyze changes in choroidal thickness in patients with recurrent rhegmatogenous retinal detachment (RRD) before and after surgical intervention and to identify factors that influence changes in choroidal thickness. Methods: A retrospective observational study was conducted on patients who underwent surgery for recurrent RRD from November 2019 to March 2023. Choroidal thickness was measured using optical coherence tomography at baseline and at 2 and 6 months postoperatively. The study analyzed the impact of various factors on choroidal thickness changes. Results: The study included 33 patients, demonstrating a significant decrease in choroidal thickness in the surgical eye compared to the fellow eye over a 6-month period. In the univariate analysis, changes in choroidal thickness were significantly correlated with changes in central retinal thickness (p = 0.048) from baseline to 2 months and with proliferative vitreoretinopathy (PVR) grade from 2 to 6 months (p = 0.009) and from baseline to 6 months (p = 0.020). In the multivariate analysis, an association was found between changes in choroidal thickness from 2 to 6 months and PVR grade (p = 0.030) Conclusions The findings indicate that surgical reattachment in eyes with recurrent RRD leads to a significant reduction in choroidal thickness. The extent of this reduction is influenced by the severity of PVR, highlighting the importance of considering PVR severity when evaluating surgical outcomes in patients with recurrent RRD.

Purpose: To analyze changes in choroidal thickness in patients with recurrent rhegmatogenous retinal detachment (RRD) before and after surgical intervention and to identify factors that influence changes in choroidal thickness. Methods: A retrospective observational study was conducted on patients who underwent surgery for recurrent RRD from November 2019 to March 2023. Choroidal thickness was measured using optical coherence tomography at baseline and at 2 and 6 months postoperatively. The study analyzed the impact of various factors on choroidal thickness changes. Results: The study included 33 patients, demonstrating a significant decrease in choroidal thickness in the surgical eye compared to the fellow eye over a 6-month period. In the univariate analysis, changes in choroidal thickness were significantly correlated with changes in central retinal thickness (p = 0.048) from baseline to 2 months and with proliferative vitreoretinopathy (PVR) grade from 2 to 6 months (p = 0.009) and from baseline to 6 months (p = 0.020). In the multivariate analysis, an association was found between changes in choroidal thickness from 2 to 6 months and PVR grade (p = 0.030) Conclusions The findings indicate that surgical reattachment in eyes with recurrent RRD leads to a significant reduction in choroidal thickness. The extent of this reduction is influenced by the severity of PVR, highlighting the importance of considering PVR severity when evaluating surgical outcomes in patients with recurrent RRD.

Purpose: To analyze changes in choroidal thickness in patients with recurrent rhegmatogenous retinal detachment (RRD) before and after surgical intervention and to identify factors that influence changes in choroidal thickness. Methods: A retrospective observational study was conducted on patients who underwent surgery for recurrent RRD from November 2019 to March 2023. Choroidal thickness was measured using optical coherence tomography at baseline and at 2 and 6 months postoperatively. The study analyzed the impact of various factors on choroidal thickness changes. Results: The study included 33 patients, demonstrating a significant decrease in choroidal thickness in the surgical eye compared to the fellow eye over a 6-month period. In the univariate analysis, changes in choroidal thickness were significantly correlated with changes in central retinal thickness (p = 0.048) from baseline to 2 months and with proliferative vitreoretinopathy (PVR) grade from 2 to 6 months (p = 0.009) and from baseline to 6 months (p = 0.020). In the multivariate analysis, an association was found between changes in choroidal thickness from 2 to 6 months and PVR grade (p = 0.030) Conclusions The findings indicate that surgical reattachment in eyes with recurrent RRD leads to a significant reduction in choroidal thickness. The extent of this reduction is influenced by the severity of PVR, highlighting the importance of considering PVR severity when evaluating surgical outcomes in patients with recurrent RRD.