吻合器痔上黏膜环形切除术治疗重度混合痔的临床体会

Clinical Experience of Procedure for Prolapse and Hemorrhoids in Treatment for Severe Mixed Hemorrhoids

目的总结吻合器痔上黏膜环形切除术(PPH)治疗重度混合痔的临床效果及关键环节的操作技巧。方法回顾性分析2006年8月至2012年11月期间在我院接受PPH治疗的183例重度混合痔或环形内痔患者的临床资料。结果本组患者手术时间为(28.5±3.1)min。所有患者均一次性完成手术。平均住院时间5.2 d,无一例患者术后出现大出血、大便失禁、感染等情况。随访1个月～3年,平均随访时间26个月,均无复发及再出血、肛门狭窄、大便失禁等并发症出现。结论 PPH作为一种微创精细手术,其操作过程中的每一个细节我们都应该掌握好,才能更有效地提高重度混合痔患者的临床治疗效果及减少并发症的发生。

Objective To summarize the clinical effect and the key part of operation of procedure for prolapse and hemorrhoids（PPH） in treatment for severe mixed hemorrhoids or circular hemorrhoids.Method The data of 183 patients with severe mixed hemorrhoids or circular hemorrhoids underwent PPH in this hospital from August 2006 to November 2012 were analyzed retrospectively.Results The operation time was（28.5±3.1） min.The operations were successfully completed at one-stage in all the patients.The average hospital stay was 5.2 d.No postoperative bleeding,fecal incontinence,and infection happened.No recurrence and complications such as postoperative rebleeding,anal stenosis,fecal incontinence,etc were found during 1 month to 3 years of follow-up with an average 26 months.Conclusions PPH as a minimally invasive operation,every detail of it should be well performed in order to improve the clinical treatment effect and reduce complications of the patients with severe mixed hemorrhoids or circular hemorrhoids.