Liu Yu-Hong, Lin Tzu-Chiao, Chen Chao-Yang, Pu Ta-Wei
Division of Colon and Rectal Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 105, Taiwan.
Division of Colon and Rectal Surgery, Department of Surgery, Tri-Service General Hospital Songshan Branch, National Defense Medical Center, Taipei 105, Taiwan.
World J Gastrointest Surg. 2024 Sep 27;16(9):2787-2795. doi: 10.4240/wjgs.v16.i9.2787.
Stapled hemorrhoidopexy (SH) is currently a widely accepted method for treating the prolapse of internal hemorrhoids. Postoperative anal stenosis is a critical complication of SH. A remedy for this involves the removal of the circumferential staples of the anastomosis, followed by the creation of a hand-sewn anastomosis. Numerous studies have reported modified SH procedures to improve outcomes. We hypothesized that our modified SH technique may help reduce complications of anal stenosis after SH.
To compare outcomes of staple removal at the 3- and 9-o'clock positions during modified SH in patients with mixed hemorrhoids.
This was a single-center, retrospective, observational study. Patients with grade III or IV hemorrhoids who underwent standard or modified SH at our colorectal center between January 1, 2015, and January 1, 2020, were included. The operation time, blood loss, length of hospital stay, and incidence of minor or major complications were recorded.
Patients with grade III or IV hemorrhoids who underwent standard or modified SH at our colorectal center between January 1, 2015 and January 1, 2020, were included. Operation time, blood loss, length of hospital stay, and incidence of minor or major complications were recorded. We investigated 187 patients (mean age, 50.9 years) who had undergone our modified SH and 313 patients (mean age, 53.0 years) who had undergone standard SH. In the modified SH group, 54% of patients had previously undergone surgical intervention for hemorrhoids, compared with the 40.3% of patients in the standard SH group. The modified SH group included five (2.7%) patients with anal stenosis, while 21 (6.7%) patients in the standard SH group had complications of anal stenosis. There was a significant relationship between the rate of postoperative anal stenosis and the modified SH: 0.251 (0.085-0.741) and 0.211 (0.069-0.641) in multiple regression analysis. The modified SH technique is a safe surgical method for advanced grade hemorrhoids and might result in a lower rate of postoperative anal stenosis than standard SH.
The modified SH technique is a safe surgical method for advanced grade hemorrhoids and might result in a lower rate of postoperative anal stenosis than standard SH.
吻合器痔上黏膜环切术（SH）是目前治疗内痔脱垂广泛接受的方法。术后肛门狭窄是SH的关键并发症。对此的一种补救方法是拆除吻合口的环形吻合钉，然后进行手工缝合吻合。许多研究报道了改良的SH手术以改善疗效。我们推测我们的改良SH技术可能有助于减少SH术后肛门狭窄的并发症。
比较混合痔患者改良SH术中3点和9点位拆除吻合钉的疗效。
这是一项单中心、回顾性观察研究。纳入2015年1月1日至2020年1月1日期间在我们结直肠中心接受标准或改良SH的Ⅲ或Ⅳ度痔患者。记录手术时间、失血量、住院时间以及轻微或严重并发症的发生率。
纳入2015年1月1日至2020年1月1日期间在我们结直肠中心接受标准或改良SH的Ⅲ或Ⅳ度痔患者。记录手术时间、失血量、住院时间以及轻微或严重并发症的发生率。我们调查了187例接受改良SH的患者（平均年龄50.9岁）和313例接受标准SH的患者（平均年龄53.0岁）。在改良SH组中，54%的患者既往曾接受过痔手术，而标准SH组为40.3%。改良SH组有5例（2.7%）患者发生肛门狭窄，而标准SH组有21例（6.7%）患者出现肛门狭窄并发症。术后肛门狭窄发生率与改良SH之间存在显著关系：多因素回归分析中分别为0.251（0.085 - 0.741）和0.211（0.069 - 0.641）。改良SH技术是治疗重度痔的一种安全手术方法，可能比标准SH导致更低的术后肛门狭窄发生率。
改良SH技术是治疗重度痔的一种安全手术方法，可能比标准SH导致更低的术后肛门狭窄发生率。
