Sameshima Takashi, Niwa Kiyoshi, Eto Tadaaki, Sameshima Kanako, Ogata Shunji, Yamamoto Yuuko, Imamura Yoshiro, Nishimata Nobuaki, Hirakawa Asami, Hamamoto Hitomi, Sameshima Yukinori
Department of Surgery, Junaikai Medical Corporation Sameshima Hospital, Kagoshima, Japan.
Department of Internal Medicine, Junaikai Medical Corporation Sameshima Hospital, Kagoshima, Japan.
J Anus Rectum Colon. 2022 Jul 28;6(3):143-149. doi: 10.23922/jarc.2021-069. eCollection 2022.
The outcomes of Mucopexy-Recto Anal Lifting (MuRAL) in hemorrhoid surgery were compared with ligation and excision (LE), and aluminum potassium sulfate and tannic acid sclerotherapy (ALTA). In this study, we conducted a 3-year follow-up study of MuRAL (380 cases) and compared it with LE (1417 cases) and ALTA (541 cases) performed at the same period. Operative time, mean hospital stay, postoperative pain, postoperative complications, and recurrence were compared and examined retrospectively. The mean operative time was the longest for MuRAL, followed by LE, and then ALTA at 29.1, 21.5, and 12.4 minutes, and the mean length of hospital stay was 6.2, 10.6, and 1.3, days, respectively. Based on the frequency of injectable analgesic use, postoperative pain was clearly milder in MuRAL and ALTA than in LE. The recurrence rates were 3.2% with MuRAL, 1.1% with LE, and 12.4% with ALTA. Early postoperative low-grade fever and bowel movement urgency were observed in all surgeries, but these were minor and did not pose a safety problem. LE is painful and requires prolonged hospitalization but is the most curative; ALTA is simple and can be performed as a day surgery but has a high recurrence rate. MuRAL was less painful than LE and had a lower recurrence rate than ALTA. In recent years, there have been various innovations in the surgical treatment of hemorrhoids, and choosing a technique that is appropriate for the condition of the hemorrhoid and patient's needs is necessary. MuRAL can be one of the options for hemorrhoid treatment as a "cure without cutting" method.
将痔上黏膜环切术(MuRAL)在痔疮手术中的结果与结扎切除术(LE)以及硫酸铝钾和鞣酸硬化疗法(ALTA)进行了比较。在本研究中,我们对MuRAL(380例)进行了为期3年的随访研究,并将其与同期进行的LE(1417例)和ALTA(541例)进行比较。回顾性比较并检查了手术时间、平均住院时间、术后疼痛、术后并发症和复发情况。MuRAL的平均手术时间最长,其次是LE,然后是ALTA,分别为29.1分钟、21.5分钟和12.4分钟,平均住院时间分别为6.2天、10.6天和1.3天。根据注射用镇痛药的使用频率,MuRAL和ALTA术后疼痛明显比LE轻。MuRAL的复发率为3.2%,LE为1.1%,ALTA为12.4%。所有手术均观察到术后早期低热和排便紧迫感,但这些症状较轻,不构成安全问题。LE疼痛且需要长时间住院,但疗效最佳;ALTA操作简单,可作为日间手术进行,但复发率高。MuRAL比LE疼痛轻,且复发率比ALTA低。近年来,痔疮手术治疗有多种创新,选择适合痔疮病情和患者需求的技术很有必要。MuRAL作为一种“不切除治愈”的方法,可以成为痔疮治疗的选择之一。