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多普勒引导痔动脉结扎联合黏膜缝合固定术与 LigaSure 辅助痔切除术治疗Ⅲ度痔的前瞻性随机对照研究。

Doppler-guided hemorrhoidal artery ligation with suture mucopexy compared with LigaSure™-assisted pile excision for the treatment of grade III hemorrhoids: a prospective randomized controlled trial.

机构信息

Emergency Department, Hengchun Tourism Hospital, Taiwan, China.

Department of Health and Welfare, Hengchun Tourism Hospital, Taiwan, China.

出版信息

Minerva Surg. 2021 Jun;76(3):264-270. doi: 10.23736/S2724-5691.20.08429-1.

Abstract

BACKGROUND

Doppler-guided hemorrhoid artery ligation and stapled hemorrhoidopexy have been used in surgical practices to avoid post-hemorrhoidectomy pain. Our study compared Doppler-guided hemorrhoid artery ligation with suture mucopexy (DGHAL-SM) and ligature-assisted pile excision (LAP) for greater than three grades of internal hemorrhoids.

METHODS

Eighty patients with greater than 3 grades of internal hemorrhoids were selected (age range: 20-28 years; average age: 23 years) between January and June 2015. The patients were randomly divided into group A (DGHAL-SM) and group B (LAP); each group had 40 patients.

RESULTS

With respect to the postoperative cure rate and anal skin tags, group A was inferior to group B, but the postoperative pain assessment and satisfaction were better than group B (P<0.001).

CONCLUSIONS

The DGHAL-SM cure rate was high; the postoperative pain was mild; 97.5% of the patients did not return to hospital because of pain. LAP has a higher cure rate than DGHAL-SM, but the postoperative pain and return rate within 6 h was as high as 65%, and the postoperative satisfaction assessment was lower than DGHAL-SM. Therefore, we recommend that DGHAL-SM for outpatient surgery in patients with greater than three grades of internal hemorrhoids.

摘要

背景

多普勒引导痔动脉结扎术和吻合器痔固定术已用于外科手术中,以避免痔切除术后疼痛。我们的研究比较了多普勒引导痔动脉结扎术加缝合黏膜固定术(DGHAL-SM)与结扎辅助痔切除术(LAP)治疗 3 度以上内痔的效果。

方法

2015 年 1 月至 6 月期间,选择 80 例 3 度以上内痔患者(年龄范围:20-28 岁;平均年龄:23 岁)。将患者随机分为 A 组(DGHAL-SM)和 B 组(LAP),每组 40 例。

结果

在术后治愈率和肛门皮赘方面,A 组不如 B 组,但术后疼痛评估和满意度优于 B 组(P<0.001)。

结论

DGHAL-SM 治愈率高,术后疼痛轻微,97.5%的患者因疼痛未返回医院。LAP 的治愈率高于 DGHAL-SM,但术后 6 小时内的疼痛和返回率高达 65%,术后满意度评估低于 DGHAL-SM。因此,我们建议 DGHAL-SM 用于 3 度以上内痔患者的门诊手术。

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