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吻合器痔固定术:一家转诊中心的 6 年经验。

Stapled haemorrhoidopexy: 6 years' experience of a referral centre.

机构信息

Service de proctologie interventionnelle, Groupe hospitalier Diaconesses-Croix, Saint Simon, Paris, France.

出版信息

Colorectal Dis. 2010 Sep;12(9):921-6. doi: 10.1111/j.1463-1318.2009.01893.x. Epub 2009 Apr 13.

Abstract

AIM

To prospectively evaluate the long-term results and assess patient satisfaction after stapled haemorrhoidopexy (HS).

METHOD

A total of 150 patients (121 male patients) with symptomatic grade II (n = 50) or III (n = 100) haemorrhoids underwent stapled HS. Patients were followed up during consultations at regular intervals, allowing prospective data collection. A final telephone follow up was also undertaken.

RESULTS

Follow up data were obtained for 130 of 150 patients (86.6%). After a median follow up of 39 months (range, 12-72), 90% of the patients were fully satisfied and 92% were free of haemorrhoidal symptoms. There were no intraoperative complications. Postoperative bleeding that required operation was observed in five patients (3.3%). Most late postoperative complications were benign and easily resolved: unexplained pain for over a month (n = 1), external haemorrhoidal thrombosis (n = 2), anal fissure (n = 6) one with hypertrophic papilla, anal fistula (n = 1), rectal stenosis (n = 1), anal incontinence for (n = 1). Eight patients needed rubber band ligation to treat persistent or recurrent symptomatic prolapse. Four patients (2.6%) were reoperated on during the follow up period but none for haemorrhoidal pathology.

CONCLUSION

Stapled HS procedure is effective and has low morbidity, high patient satisfaction and provided good long-term control of haemorrhoidal symptoms in the treatment of second and third-degree haemorrhoids.

摘要

目的

前瞻性评估吻合器痔上黏膜环切钉合术(HS)的长期疗效,并评估患者满意度。

方法

共 150 例(121 例男性)症状性 II 级(n = 50)或 III 级(n = 100)痔患者接受 HS。通过定期会诊对患者进行随访,以便前瞻性收集数据。还进行了最终的电话随访。

结果

150 例患者中的 130 例(86.6%)获得了随访数据。中位随访 39 个月(范围 12-72 个月)后,90%的患者完全满意,92%的患者无痔症状。术中无并发症。5 例(3.3%)患者发生术后出血需要手术。大多数晚期术后并发症是良性且易于解决的:超过 1 个月的不明原因疼痛(n = 1)、外痔血栓形成(n = 2)、肛裂(n = 6)、其中 1 例伴肥大乳头、肛瘘(n = 1)、直肠狭窄(n = 1)、大便失禁(n = 1)。8 例患者需要橡皮圈套扎治疗持续性或复发性症状性脱垂。在随访期间,有 4 例(2.6%)患者再次手术,但均不是针对痔病。

结论

HS 手术有效,发病率低,患者满意度高,能长期有效控制 II 度和 III 度痔的出血症状。

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