橡皮圈套扎术联合Milligan Morgan痔切除术的疗效

Outcome of the rubber band ligation with Milligan Morgan haemorrhoidectomy.

作者信息

Ali Syed Asad, Mohammad Agha Taj, Jarwar Mohammad, Imran Javeria, Siddique Akmal Jamal, Dalwani Abdul Ghafoor

机构信息

Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan.

出版信息

J Ayub Med Coll Abbottabad. 2010 Oct-Dec;22(4):56-60.

PMID:22455262

Abstract

BACKGROUND

Haemorrhoids is a common anorectal disease seen in our society. Conservative management is usually adopted for 1st and 2nd degree haemorrhoids. Patients who do not respond to above management are the candidates for other modalities of treatment which includes sclerotherapy, rubber band ligation, cryosurgery and stapler gun or open haemorrhoidectomy. The purpose of study was to compare the outcome of the Rubber band ligation with Milligan Morgan haemorrhoidectomy in patients with 2nd and 3rd degree haemorrhoids.

METHODS

Hundred diagnosed admitted patients of uncomplicated 2nd and 3rd degree piles were treated either with rubber band ligation (RBL) or open method of Milligan Morgan (OH) for the period from January 2007 to December 2007 were included in the study. Both procedures were evaluated regarding effectiveness, safety, complications after procedures, hospital stay and return to work on a written Performa. Patients with 1st and 4th degree haemorrhoids, below the age of 12 years, bleeding diathesis, associated local anorectal conditions requiring surgery, complicated haemorrhoids, recurrent and secondary haemorrhoids were excluded from the study. Follow up of all these patients was done in OPD to assess any complication and recurrence. Data was analysed through SPSS-16.0.

RESULTS

One hundred indoor patients with 2nd and 3rd degree haemorrhoids were treated either with rubber band ligation or open technique. Most (> 90%) of the patients were males. Majority of the patients were in 30-33 years age group. Fresh bleeding (90%) and constipation (45%) were the commonest symptoms followed by prolapsed, discharge and irritation. Second degree was more common than 3rd degree haemorrhoids. Intensive pain was the commonest complain after both the procedures, however faecal incontinence was not reported in either group. Hospital stay was longer in open technique (70%) compare to few hours to one day in rubber band ligation group. Return to work was earlier in patients treated with rubber band ligation.

CONCLUSION

Rubber band ligation is safe and effective method compare to open technique in 2nd and 3rd degree symptomatic haemorrhoids.

摘要

背景

痔疮是一种在社会中常见的肛肠疾病。一度和二度痔疮通常采用保守治疗。对上述治疗无反应的患者是其他治疗方式的候选对象，这些治疗方式包括硬化疗法、橡皮圈套扎术、冷冻手术以及吻合器痔上黏膜环切术或开放式痔切除术。本研究的目的是比较橡皮圈套扎术与Milligan Morgan痔切除术在二度和三度痔疮患者中的治疗效果。

方法

本研究纳入了2007年1月至2007年12月期间确诊并收治的100例无并发症的二度和三度痔疮患者，他们分别接受了橡皮圈套扎术（RBL）或Milligan Morgan开放式手术（OH）治疗。通过一份书面表格对两种手术的有效性、安全性、术后并发症、住院时间和恢复工作情况进行评估。本研究排除了一度和四度痔疮患者、12岁以下患者、出血素质患者、伴有需要手术的局部肛肠疾病患者、复杂性痔疮患者、复发性和继发性痔疮患者。所有这些患者在门诊进行随访，以评估是否有任何并发症和复发情况。数据通过SPSS - 16.0进行分析。

结果

100例室内二度和三度痔疮患者接受了橡皮圈套扎术或开放式手术治疗。大多数（>90%）患者为男性。大多数患者年龄在30 - 33岁之间。新鲜出血（90%）和便秘（45%）是最常见的症状，其次是脱垂、分泌物和瘙痒。二度痔疮比三度痔疮更常见。两种手术后最常见的主诉都是剧烈疼痛，然而两组均未报告大便失禁情况。与橡皮圈套扎术组数小时至一天的住院时间相比，开放式手术的住院时间更长（70%）。接受橡皮圈套扎术治疗的患者恢复工作更早。