Cosenza Umile M, Masoni Luigi, Conte Stefano, Simone Mauro, Nigri Giuseppe, Mari Francesco S, Milillo Andrea, Brescia Antonio
Department of General Surgery, Day Surgery Unit, Ospedale Sant’Andrea, Rome, Italy.
Am Surg. 2011 May;77(5):552-6.
In the last 10 years, stapled hemorrhoidectomy has gained worldwide consensus. We studied a day-surgery stapled hemorrhoidopexy protocol to allow shorter recovery time and cost reduction. From 2003 to 2008, we performed 292 outpatient stapled hemorrhoidopexies under spinal or local anesthesia including symptomatic Grade III and IV hemorrhoid disease. We used PPH 01 to PPH 03 staplers. We assessed early and late postoperative pain with a Visual Analog Scale, whereas clinical postoperative examinations were performed at seven days, 6 months, and 1, 3, and 5 years after surgery. The mean surgery time was approximately 18 minutes (range, 13 to 39 minutes). Of 292 patients, 39 were not dischargeable for urine retention, severe pain, or mild bleeding. Four other patients were rehospitalized within 8 days for bleeding. Twenty-one patients reported transient fecal urgency, whereas nobody reported anal incontinence. We can conclude that stapled hemorrhoidopexy is a safe and effective procedure if performed in a day-surgery unit. The complication rate is comparable to that of inpatient procedures.
在过去10年中,吻合器痔上黏膜环切术已获得全球认可。我们研究了一种日间手术吻合器痔固定术方案,以缩短恢复时间并降低成本。2003年至2008年,我们在脊髓麻醉或局部麻醉下对292例门诊患者实施了吻合器痔固定术,其中包括有症状的III级和IV级痔病患者。我们使用了PPH 01至PPH 03吻合器。我们用视觉模拟评分法评估术后早期和晚期疼痛,而术后临床检查在术后7天、6个月以及1、3和5年进行。平均手术时间约为18分钟(范围为13至39分钟)。292例患者中,39例因尿潴留、剧痛或轻度出血而无法出院。另外4例患者在8天内因出血再次住院。21例患者报告有短暂的排便紧迫感,而无人报告肛门失禁。我们可以得出结论,如果在日间手术单元进行吻合器痔固定术,该手术是安全有效的。其并发症发生率与住院手术相当。