Jeong Hyeonseok, Hwang Sunghwan, Ryu Kil O, Lim Jiyong, Kim Hyun Tae, Yu Hye Mi, Yoon Jihoon, Lee Ju-Young, Kim Hyoung Rae, Choi Young Gil
Department of Surgery, Busan Hang-Un Hospital, Busan, Korea.
Ann Coloproctol. 2017 Feb;33(1):28-34. doi: 10.3393/ac.2017.33.1.28. Epub 2017 Feb 28.
Circular stapled hemorrhoidopexy (CSH) is widely used to treat patients with grades III-IV hemorrhoids because of less pain and short hospital stay. However, this procedure is associated with some complications, such as urge to defecate, anal stenosis, staple line dehiscence, abscess and sepsis. To avoid these complications, surgeons perform a partial stapled hemorrhoidopexy (PSH). The aim of this study is to present our early experience with the PSH.
We retrospectively reviewed the medical records of 58 patients with hemorrhoids who were treated with a PSH at Busan Hang-Un Hospital from January 2016 to June 2016. A specially designed tri-window anoscope was used, and a purse string suture was made at the mucosae of the protruding hemorrhoids through the window of the anoscope. The hemorrhoidopexy was done by using a circular stapler.
Of the 58 patients included in this study, 34 were male and 24 were female patients (mean age, 50.4 years). The mean operation time was 12.4 minutes, and the mean postoperative hospital stay was 3.8 days. Three patients experienced bleeding (5.1%) 5 urinary retention (8.6%) and 5 skin tags (8.6%). Urge to defecate, tenesmus, abscess, rectovaginal fistula, anal stricture, incontinence, and recurrence did not occur.
PSH is a minimally invasive, feasible, and safe technique for treating patients with grades III-IV hemorrhoids. A PSH, instead of a CSH, can be used to treat certain patients with hemorrhoids.
吻合器痔上黏膜环切术(CSH)因疼痛轻、住院时间短而被广泛用于治疗Ⅲ-Ⅳ度痔患者。然而,该手术会引发一些并发症,如便意、肛门狭窄、吻合口裂开、脓肿和败血症。为避免这些并发症,外科医生开展了部分吻合器痔上黏膜环切术(PSH)。本研究旨在介绍我们开展PSH的早期经验。
我们回顾性分析了2016年1月至2016年6月在釜山恒恩医院接受PSH治疗的58例痔患者的病历。使用专门设计的三窗口肛门镜,通过肛门镜窗口在脱出痔的黏膜处做荷包缝合。使用圆形吻合器进行痔上黏膜环切术。
本研究纳入的58例患者中,男性34例,女性24例(平均年龄50.4岁)。平均手术时间为12.4分钟,平均术后住院时间为3.8天。3例患者出现出血(5.1%),5例出现尿潴留(8.6%),5例出现皮赘(8.6%)。未发生便意、里急后重、脓肿、直肠阴道瘘、肛门狭窄、失禁和复发。
PSH是一种治疗Ⅲ-Ⅳ度痔患者的微创、可行且安全的技术。对于某些痔患者,可使用PSH而非CSH进行治疗。