Di Vita G, Patti R, Petrone R, Arcara M, Sieli G
Università degli Studi di Palermo, Dipartimento di Discipline Chirurgiche ed Oncologiche, U.O. Di Chirurgia Generale, Endoscopica, Diagnostica ed Interventistica.
G Chir. 2003 Nov-Dec;24(11-12):422-7.
Milligan-Morgan haemorrhoidectomy is considered the best treatment for hemorrhoidal disease. Although this, many patients complaint post-operative pain that remain the worse complication. For this reason different are the trials performed in order to reduce his intensity. In this report we want to evaluate if the use of ultrasonic scalpel to perform Milligan-Morgan hemorrhoidectomy, compared with conventional surgery, could reduce post-operative pain.
30 patients with III and IV degree of haemorrhoids were included in this study and divided in two groups. In the first group Milligan-Morgan haemorrhoidectomy was performed with conventional instruments, while in the second group the some procedure was performed with ultrasonic scalpel. The duration of intervention, time hospitalization, the time to open alvus to stools, the time to return to normal activity, the complications, pain and the amount of analgesic consumption were evaluated.
In the II group's patients, it was observed a reduced time to healing with reduced spread of necrosis and inflammatory pattern, associated with reduced post-operative pain and the lower analgesic consumption.
The use of ultrasonic scalpel to perform Milligan-Morgan haemorrhoidectomy, compared with conventional instruments, reduce post-operative pain making a more short time to healing and a precocious time to return to normal activity. For this reason we believe that the use of ultrasonic scalpel, although a more elevated costs, seems to be advantageous.
Milligan-Morgan痔切除术被认为是治疗痔病的最佳方法。尽管如此,许多患者仍抱怨术后疼痛,这仍是最严重的并发症。因此,人们进行了不同的试验以减轻疼痛程度。在本报告中,我们想评估与传统手术相比,使用超声刀进行Milligan-Morgan痔切除术是否能减轻术后疼痛。
本研究纳入30例III度和IV度痔疮患者,并分为两组。第一组使用传统器械进行Milligan-Morgan痔切除术,而第二组使用超声刀进行相同手术。评估干预持续时间、住院时间、首次排便时间、恢复正常活动时间、并发症、疼痛及镇痛药物消耗量。
在第二组患者中,观察到愈合时间缩短,坏死和炎症范围减小,同时术后疼痛减轻,镇痛药物消耗量降低。
与传统器械相比,使用超声刀进行Milligan-Morgan痔切除术可减轻术后疼痛,缩短愈合时间并提前恢复正常活动。因此,我们认为使用超声刀尽管成本更高,但似乎具有优势。