Farinetti A, Saviano M, Quaranta N, Monni S
Dipartimento delle Discipline Chirurgiche e delle Emergenze, Sezione di Clinica Chirurgica, Università degli Studi, Modena e Reggio Emilia, Italy.
Minerva Chir. 2001 Apr;56(2):125-31.
The authors describe their experience of the treatment of hemorrhoidal disease using a circular stapler in order to evaluate the effectiveness of this technique.
They describe the surgical technique used in a comparative study carried out at Modena Policlinic. A transversal mucohemorrhoidal transection is performed using a circular stapler above the anorectal joint, enabling radical surgery to be completed in a single stage with a rapid and mini-invasive technique. This technique associates the resection of hemorrhoidal nodules and prolapsed mucosa with fixing the residual mucosa to the anal canal and correcting the hypertension and hematic stasis in the venous spaces by breaking the terminal branches of the superior hemorrhoidal artery. Both male and female patients were enrolled in the study, aged over 18 years old, presenting second, third and fourth degree hemorrhoidal prolapse with indications for surgery. The analysis of the long-term follow-up for possible late complications in the 60 selected cases will be reported in a later work.
The technique is easy, rapid and causes moderate pain. The postoperative complications are negligible.
A hospital stay limited to a few hours, rapid physical recovery and the absence of out-patient treatment required by this surgical technique, which is comparable to an internal closed hemorrhoidectomy, all offer undoubted advantages, also of a psychological and social nature which amply justify the higher economic and management cost linked to the use of a surgical stapler.
作者描述了他们使用圆形吻合器治疗痔病的经验,以评估该技术的有效性。
他们描述了在摩德纳综合医院进行的一项比较研究中所使用的手术技术。在肛管直肠连接处上方使用圆形吻合器进行横向黏膜痔切除术,通过快速且微创的技术在单一阶段完成根治性手术。该技术将痔核和脱垂黏膜的切除与将残余黏膜固定至肛管相结合,并通过切断痔上动脉的终末分支来纠正静脉间隙的高血压和血流淤滞。纳入研究的患者年龄均超过18岁,包括男性和女性,均有二度、三度和四度痔脱垂且有手术指征。60例入选病例可能的晚期并发症的长期随访分析将在后续工作中报告。
该技术简便、快速且疼痛轻微。术后并发症可忽略不计。
与内痔切除术相比,该手术技术住院时间仅需数小时、身体恢复快且无需门诊治疗,所有这些均具有毋庸置疑的优势,在心理和社会层面同样如此,这充分证明了与使用手术吻合器相关的较高经济和管理成本是合理的。