激光痔切除术与吻合器痔固定术：前瞻性比较研究。
LASER Haemorrhoidoplasty versus Stapler Haemorrhoidopexy: A Prospective Comparative Study.
机构信息
Dr Krisna Rani Majumder, Associate Professor of Surgical Oncology, Department of Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail:
出版信息
Mymensingh Med J. 2021 Jul;30(3):780-788.
LASER Haemorrhoidoplasty (LH) is a novel procedure in modern medical science. It is a no cut, painless and bloodless clinical procedure with comparatively fewer complications in comparison to Stapler Haemorrhoidopexy (SH) for the treatment of grade III-IV haemorrhoids. It is very applicable surgical procedure at shrinking the terminal branches of haemorrhiodal arteries with fewer complications than Stapler Haemorrhoidopexy (SH). The aim of the study was to compare LASER Haemorrhoidoplasty (LH) with Stapler Haemorrhoidopexy (SH). The comparative study was performed in Bangabandhu Sheikh Mujib Medical University (BSMMU), Anower Khan Modern Medical College and Hospital and Care Medical College and Hospital, Dhaka, Bangladesh from August 2019 to July 2020. A total of 84 patients with grade III-IV haemorrhoids were allocated into two groups: LASER Haemorrhoidoplasty (LH) and Stapler Haemorrhoidopexy (SH) with 42 patients in each group prospectively. Comparative results and post-operative follow up periods were 4 months. The mean operative time was 28.6min (LH) and 36.2min (SH) (p=0.0006). The average blood loss was 6.42ml (LH) and 12.6ml (SH) (p<0.05). The mean hospital stay 18.36 hours (LH) and 28.40 hours (SH) (p<0.05). Mean postoperative pain score (VAS) at 12 hours was 3.8 (LH) and 6.81 (SH) (p<0.05), at 24 hours was 2.6 (LH) and 4.6 (SH) (p<0.05), at 1 week was 0.46 (LH) and 0.88 (SH) (p=0.05) and at 3 months 0.04 (LH) and 0.10 (SH) (p=0.401). Complications were found in (2.4%) patients ≤1 week in the (LH) group 7(16.7%) in the (SH) group which was statistically significant (p<0.05) between the two groups. Patients with haemorrhoids treated with LASER Haemorrhoidoplasty had a better outcome than stapler haemorrhoidopexy in terms of early postoperative pain as well as complications and was associated with a shorter hospital stay and early return to work. LASER Haemorrhoidoplasty was most effective and alternative to the popular stapler Haemorrhoidopexy for grade III-IV haemorrhoids.
激光痔切除术（LH）是现代医学中的一种新方法。与吻合器痔固定术（SH）相比，它是一种无切口、无痛、无出血的临床操作，并发症相对较少，适用于治疗 III-IV 度痔。它是一种非常适用的手术方法，可减少痔动脉终末支的收缩，并发症比吻合器痔固定术（SH）少。本研究的目的是比较激光痔切除术（LH）与吻合器痔固定术（SH）。这项对比研究在孟加拉国的 Bangabandhu Sheikh Mujib 医科大学（BSMMU）、Anower Khan 现代医学院和医院以及 Care 医学院和医院进行，时间为 2019 年 8 月至 2020 年 7 月。共有 84 名 III-IV 度痔患者被分配到两组：激光痔切除术（LH）和吻合器痔固定术（SH），每组 42 名患者。比较结果和术后随访期为 4 个月。平均手术时间为 28.6 分钟（LH）和 36.2 分钟（SH）（p=0.0006）。平均出血量为 6.42ml（LH）和 12.6ml（SH）（p<0.05）。平均住院时间为 18.36 小时（LH）和 28.40 小时（SH）（p<0.05）。术后 12 小时疼痛评分（VAS）为 3.8（LH）和 6.81（SH）（p<0.05），24 小时为 2.6（LH）和 4.6（SH）（p<0.05），1 周为 0.46（LH）和 0.88（SH）（p=0.05），3 个月为 0.04（LH）和 0.10（SH）（p=0.401）。术后 1 周内，（LH）组有 7 例（16.7%）患者和（SH）组有 2.4%的患者出现并发症，差异有统计学意义（p<0.05）。与吻合器痔固定术相比，接受激光痔切除术治疗的痔疮患者在术后早期疼痛以及并发症方面有更好的效果，并且与较短的住院时间和更早的工作回归相关。激光痔切除术是治疗 III-IV 度痔的一种非常有效的替代吻合器痔固定术的方法。
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