老年患者开环式微创痔吻合术围手术期处理

Perioperative management of tissue-selecting therapy stapler in elderly patients

目的探讨开环式微创痔吻合术治疗老年人重度痔的围手术期处理及其临床疗效。方法回顾性分析68例TST手术治疗的老年患者的临床资料。结果 68例手术均获成功,平均手术时间(15.2±3.1)min,平均失血(10±1.4)ml,平均住院(5.5±2.4)d。随访1~20个月,平均随访(14.2±2.4)个月,随访64例,随访率94.1%。急性尿潴留10例;吻合口出血2例;术后疼痛4例;复发1例;低血糖1例;无吻合口狭窄、直肠阴道瘘病例。结论老年患者更适合行TST手术治疗,重视围手术期处理可以减少术后并发症,提高生活质量。

Objective To evaluate the perioperative management and therapeutic efficacy of tissue-selecting therapy stapler in elderly patients with serious hemorrhoids.Methods To analyze retrospectively the clinical data of 68 elderly patients with serious hemorrhoids treated by TST.Results All the operations were successfully completed.The average operation time was(15.2±3.1)min,the average blood loss was(10±1.4)ml and the average hospitalization time was(5.5±2.4)days。Patients were followed for 1~20months with(14.2±2.4)months for average.The follow-up rate was94.1%.Complications included urinary retention in 10casea;anastomotic bleedings in 2cases;postoperative pain in 4cases;recurrent in 1case;hypoglycemia in 1case;no case developed anastomotic stenosis and rectovaginal fistula.Conclusions Elderly patients are more suitable to TST surgery.Proper perioperative management may decrease the postoperative complications and improve the life quality of the patients.