Comparison of curative effect between tissue-selecting therapy stapler and procedure for prolapse and hemorrhoids for stage Ⅲ and Ⅳ hemorrhoids
10.3760/cma.j.issn.1673-4203.2017.08.009
- VernacularTitle:选择性痔上黏膜切除术与吻合器痔上黏膜环切术治疗Ⅲ度和Ⅳ度痔的疗效比较
- Author:
Shoulian WANG
1
;
Linhai ZHENG
;
Xiaochun NI
;
Jugang WU
;
Dengfeng ZHU
;
Bojian JIANG
;
Jiwei YU
Author Information
1. 上海交通大学医学院附属第九人民医院普外科
- Keywords:
Hemorrhoid;
Mixed hemorrhoids;
Procedure for prolapse and hemorrhoids;
Tissue-selecting therapy stapler
- From:
International Journal of Surgery
2017;44(8):535-538
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the curative effect of tissue-selecting therapy stapler and procedure for prolapse and hemorrhoids in the treatment of patients with stage Ⅲ to Ⅳ hemorrhoids.Methods The patients with stage Ⅲ to Ⅳ hemorrhoids who underwent prolapse and hemorrhoids or tissue-selecting therapy stapler surgery in the department of General Surgery,Shanghai Ninth People's Hospital and Xinhua Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Chongming Branch,from Jan.2013 to Jun.2014 were accepted and allocated to prolapse and hemorrhoids or tissue-selecting therapy stapler group.The peri-operative parameters about operative time,blood loss,postoperative hospital stay and the time required to return to normal activity were compared by t test,The postoperative complications including pain assessment and the incidence of postoperative bleeding,urine retention,faecal urgency,fecal incontinence,anal stenosis,rectovaginal fistula and recurrence rate were compared by t test and chi-square test.Rank sum test was used to compare the recurrence rate and patient's satisfaction between the two groups.Results The operation time,intraoperative bleeding volum,postoperative hospital stay and the time required to return to normal activity in the procedure for prolapse and hemorrhoids group were signifcantly higher than those in the tissue-selecting therapy stapler group (P =0.021,P =0.003,P =0.001,P ＜0.001).The pain score of procedure for prolapse and hemorrhoids group were all higher than those of the tissue-selecting therapy stapler group in the first post-operative defecation and in post-operative 24 hours and 72 hours (all P ＜ 0.001).The incidence of faecal urgency of the procedure for prolapse and hemorrhoids group in post-operative 1 month (18.6％) was higher than that of the tissue-selecting therapy stapler group (6.6％) (P =0.036).There were no statistically significant differences in the incidence of postoperative bleeding,urinary retention,recurrence rate and patient's satisfaction between two group (P ＞ 0.05).Conclusion Tissue-selecting therapy stapler was superior to the procedure for prolapse and hemorrhoids in operation time,intraoperative blood loss,postoperative pain and the incidence of faecal urgency.Long-term results demonstrate that tissue-selecting therapy stapler and prolapse and hemorrhoids have similar effectiveness.
