痔激光手术：一项前瞻性研究的短期和长期结果
Hemorrhoidal laser procedure: short- and long-term results from a prospective study.
作者信息
Crea Nicola, Pata Giacomo, Lippa Mauro, Chiesa Deborah, Gregorini Maria Elena, Gandolfi Paolo
机构信息
Department of General Surgery, San Camillo Clinic Institute, Via Turati 44, 25123 Brescia, Italy.
Department of Medical and Surgical Sciences, Second Division of General Surgery, Brescia Civic Hospital, Brescia, Italy.
出版信息
Am J Surg. 2014 Jul;208(1):21-5. doi: 10.1016/j.amjsurg.2013.10.020. Epub 2014 Jan 16.
BACKGROUND
We report the results of 2-year regular use of the hemorrhoidal laser procedure (HeLP) in 97 patients with symptomatic second- to third-grade hemorrhoids with minimal or moderate internal mucosal prolapse.
METHODS
Data on duration of the procedure, perioperative complications, postoperative pain, downgrading of hemorrhoids, resolution or persistency, and recurrence of hemorrhoidal disease (HD) were prospectively collected.
RESULTS
No significant intraoperative complications occurred. The median follow-up was 15 months. Postoperative pain was null in most patients. There were no cases of rectal tenesmus or alteration of defecation habits. Symptoms and HD downgrading reached a "plateau" at 3 to 6 months after the HeLP. At this evaluation, frequency of bleeding, pain, itching, and hemorrhoidal acute syndrome decreased by 76% to 79%. HD grade showed a significant reduction. HD recurrence rate was 5% at 2 years.
CONCLUSIONS
Our study demonstrates that the HeLP is a safe, effective, and painless technique for the treatment of symptomatic second- to third-grade hemorrhoids with minimal or moderate mucosal prolapse, ideally suitable as ambulatory treatment.
背景
我们报告了对97例有症状的二至三度痔疮且伴有轻度或中度内痔黏膜脱垂患者进行为期2年的常规痔激光手术（HeLP）的结果。
方法
前瞻性收集手术持续时间、围手术期并发症、术后疼痛、痔疮分级降低、缓解或持续情况以及痔病（HD）复发等数据。
结果
未发生明显的术中并发症。中位随访时间为15个月。大多数患者术后无疼痛。无直肠坠胀或排便习惯改变的病例。HeLP术后3至6个月，症状和HD分级达到“平台期”。在此评估时，出血、疼痛、瘙痒和痔急性综合征的发生率降低了76%至79%。HD分级显著降低。2年时HD复发率为5%。
结论
我们的研究表明，HeLP是一种安全、有效且无痛的技术，用于治疗有症状的二至三度痔疮且伴有轻度或中度黏膜脱垂，非常适合作为门诊治疗。
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