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吻合器痔上黏膜环切钉合术:技术与长期疗效。

Stapled Hemorrhoidopexy: Technique and Long Term Results.

出版信息

Chirurgia (Bucur). 2021 Jan-Feb;116(1):102-108. doi: 10.21614/chirurgia.116.1.102.

DOI:10.21614/chirurgia.116.1.102
PMID:33638331
Abstract

Stapled hemorrhoidopexy (Longo operation) is a infrequent technique in our area. A different concept from hemorrhoidectomy, a proportionally important raise in cost and a special training may have contributed to it. We report our long-term results with the standard technique. The data of 35 patients with symptomatic second- and third-degree hemorrhoids who had stapled hemorrhoidopexy using a PPH03 stapler, from 01 January 2012 to 04 December 2020, were retrospectively collected. The sex ratio male: female was 3:4 and the mean age 45 (range 28-60) years. The follow-up consisted in a rectal exam and evaluated anatomical recurrence or prolapse. The mean operative time was 42 (30-70) min. The mean parenteral analgesic doses during the first 24 h were 1,52. The mean postoperative hospital stay was 1.55 (1-2) days. A single patient needed reoperation for a staple line bleeding, two patients had a thrombosis of internal hemorrhoids and in one patient a small prolapse was diagnosed at 3 months follow-up. No hematoma, anastomotic stenosis, persistent anal pain, tenesmus, or impaired anal continence was recorded. One patient mentioned discomfort related to the presence of staples. Patients were followed-up for 6 (1-9) years. Global satisfaction rate was 94%. Conclusion: Stapled hemorrhoidopexy procedure is a safe and feasible procedure, which necessitates few analgesics and allows an early discharge. A rigorous selection of cases and a correct surgical technique allow to obtain good long-term results and offer a high level of patients satisfaction.

摘要

吻合器痔上黏膜环切钉合术(Longo 手术)在我们地区应用较少。与痔切除术不同,它的费用相对较高,需要特殊的培训,这可能是导致其应用较少的原因。我们报告采用标准技术的长期结果。

回顾性收集了 2012 年 1 月 1 日至 2020 年 12 月 4 日期间 35 例因症状性 II 度和 III 度痔接受吻合器痔上黏膜环切钉合术(PPH03 吻合器)的患者资料。男女比例为 3:4,平均年龄为 45 岁(范围 28-60 岁)。随访包括直肠检查,并评估解剖学复发或脱垂。

手术时间平均为 42 分钟(30-70 分钟)。术后 24 小时内平均使用的静脉镇痛剂量为 1.52 剂。平均住院时间为 1.55 天(1-2 天)。1 例患者因吻合线出血需要再次手术,2 例患者发生内痔血栓形成,1 例患者在 3 个月随访时诊断为小脱垂。无血肿、吻合口狭窄、持续性肛门疼痛、里急后重或肛门控便功能受损。1 例患者提到吻合钉存在相关不适。患者随访 6 年(1-9 年)。总体满意度为 94%。

结论

吻合器痔上黏膜环切钉合术是一种安全可行的手术,需要较少的镇痛药物,并允许早期出院。严格选择病例和正确的手术技术可以获得良好的长期效果,并提供高水平的患者满意度。

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Stapled Hemorrhoidopexy: Technique and Long Term Results.吻合器痔上黏膜环切钉合术:技术与长期疗效。
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