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我们是否有其他治疗痔疮出血的选择?痔动脉结扎术:16 例患者的经验。

Do We Have Another Option to Treat Bleeding Hemorrhoids? The Emborrhoid Technique: Experience in 16 Patients.

机构信息

Department of General Surgery, Infermi Hospital, Rivoli, Torino, Italy.

Department of General Surgery IRCCS AOU San Martino-IST, Genova, Italy.

出版信息

Rev Recent Clin Trials. 2021;16(1):81-86. doi: 10.2174/1574887115666200313102246.

Abstract

BACKGROUND

Hemorrhoidal disease is very common in western countries and rectal bleeding is the main symptom complained by patients. Nowadays the ultimate goal of treatment is to block the bleeding with minimally-invasive techniques to minimize post-procedural pain.

OBJECTIVE

The aim of this study is to assess the preliminary results of the emborrhoid technique (embolization of the superior rectal arteries branches) as a new tool for the proctologist to treat severe bleeding hemorrhoids causing anemia. Many categories of patients might benefit from this treatment, such as patients not eligible for conventional surgery, patients not responding to conventional treatment and fit patients with severe bleeding who refused endorectal surgical therapy.

METHODS

From May 2017 to November 2018 a total of 16 patients with chronic rectal bleeding due to hemorrhoids underwent super-selective embolization of the superior rectal arteries at the department of General Surgery in La Spezia, S. Andrea Hospital, Italy. Median age was 59 years. 14 patients were males (87.5%).

RESULTS

No post-procedural and short-term complications were observed at maximum follow up (12 months). The reduction of rectal bleeding with improvement of the quality of life was obtained in 14 patients (87.5%).

CONCLUSION

Our study, although small in number, demonstrates that embolization of superior rectal arteries with coils to treat severe bleeding due to hemorrhoids is safe and effective and does not lead to immediate complications.

摘要

背景

痔病在西方国家非常常见,直肠出血是患者主要的主诉症状。目前,治疗的最终目标是通过微创技术止血,以最大程度减轻术后疼痛。

目的

本研究旨在评估痔动脉结扎术(结扎直肠上动脉分支)作为一种治疗因贫血导致严重出血性痔的新方法的初步结果。许多类别的患者可能受益于这种治疗,例如不适合传统手术的患者、对传统治疗无反应的患者以及拒绝直肠内手术治疗的严重出血的适宜患者。

方法

2017 年 5 月至 2018 年 11 月,意大利拉斯佩齐亚圣安德烈亚医院普外科对 16 例因痔慢性直肠出血的患者进行了超选择性直肠上动脉栓塞术。中位年龄为 59 岁,14 例为男性(87.5%)。

结果

在最长随访期(12 个月)内,未观察到术后和短期并发症。14 例患者(87.5%)直肠出血减少,生活质量得到改善。

结论

我们的研究虽然数量较少,但表明采用弹簧圈栓塞直肠上动脉治疗严重出血性痔是安全有效的,不会导致即刻并发症。

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