Yuan Chenchen, Zhou Chongjun, Xue Rong, Jin Xiaofeng, Jin Chun, Zheng Chenguo
The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Graduate Education Management Division, Wenzhou Medical University, Wenzhou, China.
Front Surg. 2022 Mar 3;9:838742. doi: 10.3389/fsurg.2022.838742. eCollection 2022.
Tissue selection therapy staplers (TSTs) are widely used to treat prolapsing hemorrhoids; however, some disadvantages exist. We describe a modified technique for the treatment of prolapsing hemorrhoids, with the aim of minimizing the risk of anal stenosis and anal incontinence and reducing the impact of postoperative complications from the stapling technique. We applied a modified TST procedure, and the preliminary data were used to test the efficacy and safety of this new technique.
We conducted a retrospective study of patients who underwent modified TST for prolapsing hemorrhoids at our department between January 2018 and January 2020. All patients received a modified TST. Most prolapsing hemorrhoids were not segmentally resected and were instead selectively removed. The demographics, preoperative characteristics, postoperative complications, therapeutic effects, and patient satisfaction were collected and analyzed.
A total of 106 patients were included in the study; 53 were men and 53 women (mean age, 49.24 years). The mean operative time was 55.01 min, and the mean hospital stay was 7.82 days. After surgery, three patients experienced bleeding (2.83%), 2 patients experienced anal discharge (1.89%), 2 patients experienced tenesmus (1.89%), and 5 patients experienced anal tags (4.72%). Anal incontinence, persistent post stapler pain, rectovaginal fistula and anal stenosis did not occur. Two patients developed recurrent symptomatic hemorrhoids (1.89%). The total effective rate of the surgery and the total satisfaction rate of the patients was 97.17%.
The modified tissue selection therapy stapler technique was a satisfactory and economical treatment for prolapsing hemorrhoids at a follow-up period of 1 year. The modified TST was associated with reduced anal stenosis and anal incontinence, less persistent post stapler pain and a minimal risk of rectovaginal fistula.
组织选择性痔吻合器（TST）被广泛用于治疗内痔脱垂；然而，该方法存在一些缺点。我们描述了一种治疗内痔脱垂的改良技术，旨在将肛门狭窄和肛门失禁的风险降至最低，并减少吻合器技术术后并发症的影响。我们应用了改良的TST手术，并使用初步数据来测试这项新技术的疗效和安全性。
我们对2018年1月至2020年1月在我科接受改良TST治疗内痔脱垂的患者进行了一项回顾性研究。所有患者均接受改良TST治疗。大多数内痔脱垂未进行分段切除，而是进行选择性切除。收集并分析患者的人口统计学资料、术前特征、术后并发症、治疗效果及患者满意度。
本研究共纳入106例患者，其中男性53例，女性53例（平均年龄49.24岁）。平均手术时间为55.01分钟，平均住院时间为7.82天。术后，3例患者出现出血（2.83%），2例患者出现肛门溢液（1.89%），2例患者出现里急后重（1.89%），5例患者出现皮赘（4.72%）。未发生肛门失禁、吻合器术后持续疼痛、直肠阴道瘘和肛门狭窄。2例患者出现复发性症状性痔（1.89%）。手术总有效率和患者总满意率为97.17%。
改良组织选择性痔吻合器技术在1年的随访期内是一种令人满意且经济的内痔脱垂治疗方法。改良TST可减少肛门狭窄和肛门失禁，减轻吻合器术后持续疼痛，降低直肠阴道瘘的风险。
