经导光肛门自动牵开镜改良外剥内扎加悬吊术治疗重度痔232例

The Improved Procedure of External Dissection and Internal Ligation plus Suspension under Photoconductive Automatic Anus Dilator in the Treatment of Severe Hemorrhoids：Analysis of 232 Cases

为提高重度痔手术治疗的效果，采用导光肛门自动牵开镜改良外剥内扎加悬吊术治疗重度痔232例，分析其手术方式及疗效。结果显示，所有病例内痔悬吊后脱出痔核、直肠黏膜及下移肛垫回缩显著，外痔剥离切除后无肛门重度水肿，同时明显减轻了术后疼痛，无继发性大出血、肛门直肠狭窄、黏膜外翻、肛门感觉性失禁等并发症的发生，近期治愈率100％，平均愈合时间20d，治愈后肛门平整光滑。随访3个月至2年，无痔核脱出，排便通畅，肛门功能正常。结果表明，该手术方法符合痔的现代概念，适用于条件所限或不宜选择PPH及传统M-M手术治疗困难的患者，疗效满意。

The clinical data of 232 patients with severe hemorrhoids who had undergone the improved procedure of external dissection and internal ligation plus suspension under photoconductive automatic anus dilator were analyzed retrospectively, so as to enhance curative effect of the operation for this disease. As resuits,all the prolapsed hemorrhoids,rectal mueosa and anocushion were retracted markedly;no severe anal edema oecurred;postoperative pain was notably reduced; such complications as secondary massive hemorrhage,anorectal stricture,mueosa eversion and anal sensitive incontinence was not round,the average healing duration of time was 20 days, the level and smooth of anus and the cure rate of short-term period of time was 100 %. Follow up of 3-24 months showed that no hemorrhoids were prolapsed, unobstructed defecation, the anal function was normal, and defecation was normal too. It is concluded that this improved combined procedure is suitable for those patients whose conditions are not suited to local equipments,PPH or M-M procedures.