Sabanci U, Ogun I, Candemir G
Department of General Surgery, Yuzuncu Yil University, Van, Turkey.
J Int Med Res. 2007 Nov-Dec;35(6):917-21. doi: 10.1177/147323000703500622.
Patients with grade III or IV haemorrhoids underwent stapled haemorrhoidopexy or Ferguson haemorrhoidectomy (50 patients in each group) between June 2000 and April 2003. Six patients (12.0%) receiving stapled haemorrhoidopexy experienced complications: bleeding (2.0%) and haematoma (4.0%); late complications were anal fissure (4.0%) and recurrence of haemorrhoidal disease (2.0%). Bleeding was treated during the operation by suture ligation and fissures by sphincterotomy; haematomas resolved spontaneously with conservative medical treatment. Of those undergoing Ferguson haemorrhoidectomy, no bleeding occurred postoperatively, however urinary retention was seen in three patients (6.0%) We conclude that Ferguson haemorrhoidectomy was safer than stapled haemorrhoidopexy for bleeding complications, but stapled haemorrhoidopexy was superior to the Ferguson technique in terms of postoperative pain (4.2 versus 7.4 on day 1 after operation, decreasing to 2.2 versus 4.2 at 1 week for stapled haemorrhoidopexy compared with Ferguson haemorrhoidectomy, respectively), duration of hospital stay (92% undergoing stapled haemorrhoidopexy discharged on postoperative day 1) and time to return to normal activities (10.0+/-1 versus 28.0+/-2 days, respectively).
2000年6月至2003年4月期间，III级或IV级痔疮患者接受了吻合器痔上黏膜环切术或弗格森痔切除术（每组50例患者）。接受吻合器痔上黏膜环切术的6例患者（12.0%）出现并发症：出血（2.0%）和血肿（4.0%）；晚期并发症为肛裂（4.0%）和痔病复发（2.0%）。术中出血通过缝合结扎治疗，肛裂通过括约肌切开术治疗；血肿通过保守药物治疗自行消退。接受弗格森痔切除术的患者术后无出血发生，但有3例患者（6.0%）出现尿潴留。我们得出结论，在出血并发症方面，弗格森痔切除术比吻合器痔上黏膜环切术更安全，但吻合器痔上黏膜环切术在术后疼痛（术后第1天分别为4.2和7.4，吻合器痔上黏膜环切术与弗格森痔切除术相比，1周时分别降至2.2和4.2）、住院时间（92%接受吻合器痔上黏膜环切术的患者术后第1天出院）以及恢复正常活动时间（分别为10.0±1天和28.0±2天）方面优于弗格森技术。
