Madiba T E, Esterhuizen T M, Thomson S R
Department of Surgery, University of KwaZulu-Natal, Durban.
S Afr Med J. 2009 Jan;99(1):43-53.
The procedure for prolapse and haemorrhoids (PPH) was introduced to address the postoperative pain following excisional haemorrhoidectomy (EH).
To assess the efficacy of both procedures to treat haemorrhoids.
Literature review using MEDLINE. Articles addressing PPH and ER were included.
RCTs comparing PH and PPH with > or = 20 patients.
Primary endpoints were pain, operative time, hospital stay, satisfaction with procedure and time to return to normal activity. Secondary endpoints such as recurrence and complications were collated for descriptive analysis. A meta-analysis was performed using the random effects model on studies reporting 'mean' and SD or ESM.
PPH was associated with less postoperative pain, less operative time, shorter hospital stay and earlier return to normal activities compared with EH. There appears to be no significant difference in satisfaction with the procedure. There was no difference between the two procedures in terms of complications. There were more recurrences after PPH.
Compared with PH, PPH is associated with less postoperative pain, reduced operative time and hospital stay and earlier return to normal activity, and a trend towards improved patient satisfaction. The rate of recurrence appears higher with PPH.
痔上黏膜环切术（PPH）被引入以解决外剥内扎痔切除术（EH）后的术后疼痛问题。
评估这两种治疗痔疮方法的疗效。
使用MEDLINE进行文献综述。纳入涉及PPH和EH的文章。
比较PPH和EH且患者≥20例的随机对照试验。
主要终点为疼痛、手术时间、住院时间、对手术的满意度以及恢复正常活动的时间。整理次要终点如复发和并发症进行描述性分析。对报告“均值”和标准差或标准误的研究使用随机效应模型进行荟萃分析。
与EH相比，PPH术后疼痛更少、手术时间更短、住院时间更短且更早恢复正常活动。在对手术的满意度方面似乎无显著差异。两种手术在并发症方面无差异。PPH术后复发更多。
与EH相比，PPH术后疼痛更少、手术时间和住院时间缩短且更早恢复正常活动，并且有患者满意度提高的趋势。PPH的复发率似乎更高。
