Scotto di Carlo Ennio, Medolla Arcangelo, Savino Francesco, Bellizzi Luigino, Calabria Paolo
UOC di Chirurgia Generale, Presidio Ospedaliero di Sapri, Salerno.
Chir Ital. 2007 May-Jun;59(3):347-53.
The authors present their experience with the treatment of haemorrhoidal prolapse using the Longo technique. From March 2005 to February 2006, 56 patients underwent the above-mentioned procedure, 49 of them (87.5%) suffering from third-degree and 7 (12.5%) from fourth-degree prolapse. The most common symptom, present in all patients, was rectal bleeding. Fifty patients (89.3%) were treated as one-day surgery cases. All patients were monitored at 1 week and1 month after the operation, 29 patients (51.8%) were monitored for 6 months postoperatively and 4 patients (7.1%) for 1 year. The mean follow-up was 5.6 months (range: 1 week-1 year). In our experience, the most important clinical evidence consisted in very low postoperative pain intensity, early return to work, a low rate of minor complications and the absence of major complications. It is necessary to ensure that both the details of technique and the indications for the procedure are fully considered and complied with and that an effective learning curve is implemented in order to achieve good postoperative results. We suggest the adoption of an eclectic approach that does not preclude more traditional operative techniques for the treatment of fourth-degree prolapse and prolapse with large external haemorrhoids. We consider this to be a sine qua non for an appropriate surgical approach to the disease.
作者介绍了他们使用龙氏技术治疗痔脱垂的经验。2005年3月至2006年2月,56例患者接受了上述手术,其中49例(87.5%)为三度脱垂,7例(12.5%)为四度脱垂。所有患者最常见的症状是直肠出血。50例(89.3%)患者作为日间手术病例接受治疗。所有患者在术后1周和1个月进行监测,29例(51.8%)患者在术后6个月进行监测,4例(7.1%)患者在术后1年进行监测。平均随访时间为5.6个月(范围:1周 - 1年)。根据我们的经验,最重要的临床证据包括术后疼痛强度极低、早期恢复工作、 minor并发症发生率低以及无 major并发症。必须确保充分考虑并遵守技术细节和手术适应症,并实施有效的学习曲线,以取得良好的术后效果。我们建议采用一种折衷的方法,对于四度脱垂和伴有大的外痔脱垂的治疗,不排除更传统的手术技术。我们认为这是对该疾病采取适当手术方法的必要条件。