Department of Traditional Chinese Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China.
BMC Gastroenterol. 2023 Aug 31;23(1):293. doi: 10.1186/s12876-023-02933-x.
Milligan-Morgan hemorrhoidectomy (MMH) is the most widely used surgical procedure because of its precise curative effect, but it has the disadvantages such as obvious postoperative pain and bleeding. To retrospectively evaluate the efficacy and safety of MMH combined with non-Doppler hemorrhoidal artery ligation (MMH + ND-HAL) for the treatment of grade III/IV hemorrhoids.
We conducted a retrospective analysis of 115 patients with grade III/IV hemorrhoids, 53 patients had received MMH + ND-HAL, and the remaining 62 patients received MMH. We collected and compared demographic and clinical characteristics of both groups, including intraoperative blood loss, postoperative visual analog scale (VAS) for pain, analgesic consumption, postoperative bleeding, perianal incision edema, urinary retention, anal stenosis, anal incontinence incidence, recurrence rate (prolapse or bleeding), and patient satisfaction.
The VAS pain score of the first postoperative defecation and at the postoperative 12 h, 1 day, 2 days, 3 days, and 7 days, as well as the total analgesic consumption within 7 days, for the MMH + ND-HAL group were lower than those for the MMH group (P < 0.05). The intraoperative blood loss, the incidence of postoperative bleeding, perianal incision edema, and urinary retention in the MMH + ND-HAL group was lower than that in the MMH group (P < 0.05). No anal stenosis or anal incontinence occurred in either group. At follow-up by telephone or outpatient 12 months after surgery, the recurrence rate (prolapse or bleeding) was lower in the MMH + ND-HAL group than in the MMH group (P < 0.05), and satisfaction was higher in the MMH + ND-HAL group than in the MMH group (P < 0.05).
MMH + ND-HAL was a satisfactory surgical modality for treating III/IV hemorrhoids.
Milligan-Morgan 痔切除术（MMH）是最广泛应用的手术方法，因其确切的疗效，但有明显的术后疼痛和出血等缺点。回顾性评价 MMH 联合非多普勒痔动脉结扎术（MMH+ND-HAL）治疗 III/IV 度痔的疗效和安全性。
我们对 115 例 III/IV 度痔患者进行回顾性分析，其中 53 例行 MMH+ND-HAL，62 例行 MMH。收集并比较两组患者的一般资料和临床特征，包括术中出血量、术后疼痛视觉模拟评分（VAS）、镇痛药物消耗、术后出血、肛门切口水肿、尿潴留、肛门狭窄、肛门失禁发生率、复发率（脱垂或出血）和患者满意度。
MMH+ND-HAL 组术后首次排便时、术后 12h、1d、2d、3d、7d 的 VAS 疼痛评分以及术后 7d 内总镇痛药物消耗量均低于 MMH 组（P<0.05）。MMH+ND-HAL 组术中出血量、术后出血发生率、肛门切口水肿、尿潴留发生率均低于 MMH 组（P<0.05）。两组均无肛门狭窄和肛门失禁发生。术后 12 个月电话或门诊随访时，MMH+ND-HAL 组复发率（脱垂或出血）低于 MMH 组（P<0.05），满意度高于 MMH 组（P<0.05）。
MMH+ND-HAL 是治疗 III/IV 度痔的一种满意的手术方法。
