Digestive Surgery Division, Department of Surgery, Faculty of Medicine, Gadjah Mada University/Dr, Sardjito Hospital, Jl. Kesehatan No. 1, Yogyakarta, 55281, Indonesia.
BMC Gastroenterol. 2022 Aug 9;22(1):379. doi: 10.1186/s12876-022-02409-4.
Post-operative pain is the main problem of hemorrhoidectomy. An adequate pain management can promote early mobilization, fast recovery, and reduce hospitalization costs. This study aimed to investigate the role of preoperative anal dilatation using a standardized anal dilator in reducing post-operative pain.
This study was conducted using randomized prospective trial with a total of 40 subjects, who were divided into 2 groups. The first group received preoperative anal dilatation using a 33 mm anal dilator for 20 min, while the second group did not. The post-operative anal pain, edema, bleeding, and incontinence were observed in the first, second, and seventh day.
The post-operative pain was significantly lower in the preoperative anal dilatation group for all days of observation (p < 0.05). The difference of post-operative bleeding and edema between groups were not significant. Fecal incontinence was initially significantly higher in the preoperative anal dilatation group, but the difference was insignificant at the seventh day (p = 0.500).
Preoperative anal dilatation significantly reduced post-operative pain. The side effect of fecal incontinence was only temporary until the seventh day after surgery. Trial Registration This trial was registered on Thai Clinical Trials Registry (TCTR) with TCTR identification number TCTR20220314002, on 14/03/2022 (retrospectively registered).
术后疼痛是痔切除术的主要问题。充分的疼痛管理可以促进早期活动、快速康复并降低住院费用。本研究旨在探讨术前使用标准化肛门扩张器进行肛门扩张在减轻术后疼痛中的作用。
本研究采用随机前瞻性试验，共纳入 40 例患者，分为两组。第一组在术前使用 33mm 的肛门扩张器扩张肛门 20 分钟，第二组不进行肛门扩张。观察术后第 1、2、7 天的肛门疼痛、水肿、出血和失禁情况。
在所有观察日，术前肛门扩张组的术后疼痛明显低于未扩张组（p<0.05）。两组术后出血和水肿的差异无统计学意义。术前肛门扩张组在术后第 1 天的粪便失禁发生率明显较高，但在第 7 天差异无统计学意义（p=0.500）。
术前肛门扩张可显著减轻术后疼痛。粪便失禁的副作用仅在术后第 7 天之前暂时存在。
本试验于 2022 年 3 月 14 日在泰国临床试验注册中心（TCTR）注册，注册号为 TCTR20220314002（回顾性注册）。
