采用可重复使用吻合器行吻合器痔切除术并发症分析

Research on Complications Related with Use of Reusable Stapling Device in Stapled Hemorrhoidectomy for Prolapsed Hemorrhoids

目的评价采用国产可重复使用吻合器进行重度痔吻合器切除术的并发症及安全性。方法回顾分析2003年J月—2006年6月连续进行的135例环状脱垂痔行吻合器痔切除术的手术方法、术后疗效及并发症。结果135例中133例完成手术，2例因吻合器机械故障改行常规痔切除术。手术时间15—30min，平均住院日5．1d。术后并发症包括：尿潴留69例，麻醉性镇痛剂止痛33例，术后吻合口出血4例。吻合口狭窄2例。肛瘘1例。术后半年内痔核再次脱出2例，吻合口处钛钉松脱致吻合口糜烂1例。结论采用国产可重复使用吻合器行环状痔切除术安全可靠，近期总体疗效满意。应注意掌握吻合器的正确使用方法，避免与其相关的并发症。

Objective To estimate the safety and the efficiency of reusable stapling devices in stapled hemorrhoidectomy. Methods The operative techniques ,postoperative ,complications and the short-term outcomes of 135 cases of prolapsed hemorrhoids treated by stapled hemorrhoideetomy using reusable stapling devices from Jul, 2003 to Jun, 2006 were reviewed. Results .The operation was successful in 133 patients. In the rest 2 cases ,the procedure failed because of mechanical problems of the stapling devices. Operating time varied from 15 - 30 minutes. The mean hospitalization was 5.1 days. Major postoperative complications included urinary reten- tion in 69 patients, analgesic requirement in 47, rectal bleeding in 4, anastamotic stricture in 2, anal fistula in 1, recurrent prolapse in 2, and retained staples at the staple line in 1 within 6 months after operation. Conclusion Stapled hemorrhoidectomy using reusable stapling devices made in China is safe for prolapsed hereoF（holds with satisfactory short term outcomes. Cautions should be given to the details of the stapling techniques to avoid related complications.