Towliat Kashani Seyed Mohsen, Mehrvarz Shaban, Mousavi Naeini Seyed Morteza, Erfanian Reza
Baqiyatallah Research Center for Gastroentrology and Liver disease, Tehran, IR Iran.
Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
Trauma Mon. 2012 Jan;16(4):175-7. doi: 10.5812/kowsar.22517464.3363. Epub 2012 Jan 15.
The stapled hemorrhoidopexy (SH) is a procedure for prolapse and hemorrhoids . At first SH seemed to be a good alternative for the Milligan Morgan (MM) hemorrhoidectomy and preliminary results in early 2000 confirmed it. However, further studies and evaluation of long-term results showed poorer outcomes.
This study aimed to evaluate and compare the results of these 2 surgical procedures in terms of recovery, improvement of symptoms and incidence of complications.
This study was conducted from April 2008 to August 2010. A total of 80 patients were divided into 2 groups of 40 each. In the SH group, there were 24 males (60%) and 16 females (40%) with a mean age of 48 ± 12.5 yrs. In the MM group, there were 30 males (75%) and 10 females (25%) with a mean age of 50.6 ± 17.3 yrs. Patients with grade 3 and 4 prolapsed hemorrhoids were entered in the study. Data were entered using SPSS software and analyzed using t-test and Chi-square test.
The two groups had no significant difference in terms of age or sex. Duration of surgery was 35 ± 7 minutes in the SH and 23.6 ± 13.5 minutes in the MM group. This difference was statistically significant (P = 0.000). Post-operative pain and complete pain relief was slightly lower in the MM group (not significant). Hospital stay was significantly longer in the MM group (P = 0.003). Return to work was similar in both groups. Three patients in the SH group (7.5%) and 2 in the MM group (5%) had hemorrhoid recurrence.
Both techniques are efficient treatment methods for grade III and IV hemorrhoids and are associated with greater than 95% recovery rate. Overall, outcomes are the same in both techniques. Lower postoperative pain was the only advantage of SH over MM technique.
吻合器痔上黏膜环切术（SH）是一种用于治疗痔脱垂的手术方法。起初，SH似乎是Milligan Morgan（MM）痔切除术的一个不错替代方案，21世纪初的初步结果证实了这一点。然而，进一步的研究和长期结果评估显示其效果较差。
本研究旨在从恢复情况、症状改善及并发症发生率方面评估和比较这两种手术方法的结果。
本研究于2008年4月至2010年8月进行。共80例患者被分为两组，每组40例。SH组中，男性24例（60%），女性16例（40%），平均年龄48±12.5岁。MM组中，男性30例（75%），女性10例（25%），平均年龄50.6±17.3岁。纳入研究的为3级和4级痔脱垂患者。数据使用SPSS软件录入，并采用t检验和卡方检验进行分析。
两组在年龄或性别方面无显著差异。SH组手术时间为35±7分钟，MM组为23.6±13.5分钟。这种差异具有统计学意义（P = 0.000）。MM组术后疼痛及疼痛完全缓解情况略低（无显著差异）。MM组住院时间显著更长（P = 0.003）。两组恢复工作情况相似。SH组3例患者（7.5%）和MM组2例患者（5%）出现痔复发。
两种技术都是治疗III级和IV级痔的有效方法，恢复率均超过95%。总体而言，两种技术的结果相同。SH相对于MM技术的唯一优势是术后疼痛较低。
