Colombo-Benkmann Mario, Tübergen Dirk, Buchweitz Olaf, Senninger Norbert
Department of General and Visceral Surgery, University of Münster, Münster, Germany.
Dis Colon Rectum. 2008 Nov;51(11):1681-5. doi: 10.1007/s10350-008-9311-7. Epub 2008 May 17.
Treatment options for anal and perianal warts caused by human papillomavirus include topical application of cytotoxic substances or immunomodulators and ablative procedures. The objective of this prospective study was the evaluation of the ultrasound-driven Harmonic Scalpel (Ethicon Endo-Surgery, Norderstedt, Germany) for resection of anal and perianal condylomata acuminata.
Eight men and three women (age range, 26-72 years) with anal and perianal condylomata acuminata were treated by a Harmonic Scalpel blade operating at a vibration frequency of 55.5 kHz and within a temperature range of 65 degrees C to 120 degrees C. Nine patients were treatment naïve, and two patients had recurrent disease. Follow-up ranged from 4 to 26 months.
Seven patients had perianal condylomata, two patients had exclusively intra-anal, and two patients had perianal and intra-anal warts. All condylomata were excised in a single-step procedure with complete clearing without injury of subepidermal layers. We observed no intraoperative or postoperative complications. No recurrences occurred during follow-up.
The Harmonic Scalpel has been an effective and safe method for the treatment of anal perianal human papillomavirus condylomata without recurrent warts. Subepidermal skin levels remained uninjured; thus, no complications or unsatisfactory cosmesis occurred.
人乳头瘤病毒引起的肛门和肛周疣的治疗选择包括细胞毒性物质或免疫调节剂的局部应用以及切除手术。这项前瞻性研究的目的是评估超声驱动的谐波手术刀（美国强生公司旗下爱惜康内镜外科公司，德国诺德施泰特）用于切除肛门和肛周尖锐湿疣。
8名男性和3名女性（年龄范围26 - 72岁）患有肛门和肛周尖锐湿疣，采用振动频率为55.5千赫兹、温度范围在65摄氏度至120摄氏度的谐波手术刀刀片进行治疗。9名患者为初治患者，2名患者有复发病史。随访时间为4至26个月。
7名患者有肛周尖锐湿疣，2名患者仅患有肛管内尖锐湿疣，2名患者同时有肛周和肛管内疣体。所有疣体均通过单步手术切除，完全清除且未损伤表皮下层。我们未观察到术中或术后并发症。随访期间无复发情况。
谐波手术刀是治疗肛门和肛周人乳头瘤病毒尖锐湿疣且无疣体复发的一种有效且安全的方法。表皮下层未受损伤；因此，未出现并发症或不理想的美容效果。
