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| Effect of Stapler Hemorrhoid Excision Combined with Partial Anal Sphincterotomy on Edema of Wound Margin and Anal Function after Severe Mixed Hemorrhoids Operation |
| WANG Meng, NING Yuyong, WU Wei, et al |
| General Hospital of Anhui Wanbei Coal and Power Group, Anhui Suzhou 234000, China |
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Abstract Objective: To investigate the effects of surgical procedures for prolapseand oral sphincterotomy (PPH) combined with partial anal sphincterotomy for severe mixed hemorrhoids on postoperative wound edema and anal function. Methods: The data of 103 patients with severe mixed hemorrhoids admitted to the General Hospital of Anhui Wanbei Coal and Power group from January 2019 to November 2020 were retrospectively analyzed, and they were divided into the combined group (PPH + amputation, n = 52) and the control group (PPH alone, n = 51) according to different surgical methods. After 7 days of treatment, the total effective rate, postoperative edema and anal function of the two groups were observed and compared. Results: The total effective rate (100%) of the combination group was significantly higher than that of the control group (90.20%), and the difference was statistically significant (χ2=5.289, P<0.05). The postoperative edema in the combined group was significantly lighter than that in the control group, the difference was statistically significant (χ2=19.443, P<0.05). The postoperative wound edge edema score [(2.34±1.05) points] of the combined group was significantly lower than that of the control group [(5.24±2.67) points], and the difference was statistically significant (t=7.658, P<0.05). After 7 days of treatment, the difference between the anal function indicators of the anal canal resting pressure and diastolic pressure before and after treatment in the combined group was significantly higher than that of the control group, and the differences were statistically significant (t=6.449, 6.540, P<0.05). The total incidence of postoperative complications in the combined group (3.85%) was significantly lower than that in the control group (13.73%), and the difference was statistically significant (P<0.05). Conclusion: Compared with stapler hemorrhoidectomy, stapler hemorrhoidectomy combined with anal sphincterotomy in the treatment of severe mixed hemorrhoids can significantly improve the clinical efficacy, alleviate the edema of the wound margin, improve the anal function and reduce the incidence of postoperative complications.
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[1] Brown S,Tiernan J,Biggs K,et al.The HubBLe Trial:haemorrhoidal artery ligation (HAL) versus rubber band ligation(RBL) for symptomatic second- and third-degree haemorrhoids : a multicentre randomised controlled trial and health-economic evaluation[J].Health Technol Assess,2016,20(88): 1~150.
[2] Davis BR,Lee-Kong SA,Migaly J,et al.The american society of colon and rectal surgeons clinical practice guidelines for the management of hemorrhoids[J].Dis Colon Rectum,2018,61(3):284~292.
[3] 李海宏.肛门内括约肌切断术联合吻合器痔上黏膜环切术治疗HI、IV度混合涛效果观察[J].中国实用医刊,2017,44(24):36~39.
[4] 国家中医药管理局.中医肛肠科病证诊断疗效标准[M].南京:南京大学出版社,1994.11.
[5] 许达薇,许胜男,李波.PPH 联合MMH 治疗重度环状混合痔对患者创缘水肿及肛管压力的影响[J].河北医药,2018,40(9):83~86.
[6] 黄俊,何文涛,胡娜.吻合器痔上黏膜环切术与传统手术对重度痔疮的疗效及预后的影响比较[J].中国现代普通外科进展,2017,20(8):648~650.
[7] 陈益家,首汉蓉,龚照岚.PPH联合部分肛门内括约肌切断术对疼痛及预后影响[J]..中国现代普通外科进展,2015,18(11):881.
[8] 袁瑞富.部分肛门内括约肌切断术对重度混合痔的远期治疗效果及安全性[J].临床医药文献电子杂志,2019,6(30):36. |
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2021, Vol. 27 
