Lim Y K, Eu K W, Ho K S, Ooi B S, Tang C L
Department of Colorectal Surgery, Singapore General Hospital, Singapore.
Tech Coloproctol. 2006 Mar;10(1):43-6. doi: 10.1007/s10151-006-0249-3. Epub 2006 Mar 15.
Stapled hemorrhoidopexy is an established treatment for hemorrhoidal disease. We evaluated our experience with stapled hemorrhoidopexy using the new Procedure for Prolapse and Hemorrhoids (PPH03) Proximate HCS hemorrhoidal circular stapler (Ethicon Endo-Surgery).
We retrospectively reviewed clinical data for 238 patients who had undergone stapled hemorrhoidopexy in our department over a 2-month period. Patients were followed-up for a median of 3.5 weeks (range, 1-11 weeks) and were analyzed for complications and resolution of symptoms.
The hemorrhoids treated were third- and fourth-degree, as well as second degree (after failure of other therapies). Mean duration of surgery was 12.7 minutes (range, 5-20 minutes) and the majority of patients was treated with an ambulatory procedure. Most patients were discharged within 6 hours after surgery. On follow-up, 3.7% of patients had minor complaints after surgery. Technically, the new PPH03 stapler device has a quickclose knob, which allows rapid opening and closing. The closed staple height of 0.75 mm increases staple line compression on tissue and key blood vessels, hence minimizing bleeding. Prior to this, stapled hemorrhoidopexy was done using the PPH01 device.
Stapled hemorrhoidopexy using the new PPH03 stapler is a safe, short and effective procedure in the management of hemorrhoids. It can be done in the ambulatory setting and patients have few postoperative complications.
吻合器痔上黏膜环切术是治疗痔病的一种既定疗法。我们评估了使用新型痔上黏膜环切术(PPH03)近端HCS痔环形吻合器(爱惜康内镜外科公司)进行吻合器痔上黏膜环切术的经验。
我们回顾性分析了在2个月内于我科接受吻合器痔上黏膜环切术的238例患者的临床资料。对患者进行了中位时间为3.5周(范围1 - 11周)的随访,并分析并发症及症状缓解情况。
所治疗的痔为三度和四度,以及二度(其他治疗失败后)。平均手术时间为12.7分钟(范围5 - 20分钟),大多数患者接受门诊手术。大多数患者在术后6小时内出院。随访时,3.7%的患者术后有轻微不适。从技术上讲,新型PPH03吻合器有一个快速关闭旋钮,可实现快速开合。0.75毫米的闭合钉高增加了钉合线对组织和关键血管的压迫,从而减少出血。在此之前,吻合器痔上黏膜环切术使用的是PPH01器械。
使用新型PPH03吻合器进行吻合器痔上黏膜环切术是治疗痔的一种安全、简短且有效的方法。可在门诊进行,患者术后并发症少。