痔上黏膜环形切除钉合术(PPH)再思考

Rethinking on the procedure for prolapse and hemorrhoids

痔上黏膜环形切除钉合术(PPH)为痔的治疗提供了新理念,至今已在临床运用20余年。PPH既有缩短手术时间、术中出血少、术后疼痛轻等显著优势,也伴发一些并发症,诸多评论不一。笔者就PPH治疗脱垂性痔的病理生理学再认识,结合近期远期疗效、术后并发症及技术改进等,了解PPH产生的过程,适应证、禁忌证、并发症、近远期效果,以及国内外结直肠肛门外科医生做出的技术改进,并为以后继续服务于临床做依据。

Procedure for prolapse and hemorrhoids(PPH)has provided a new idea for the treatment of hemorrhoids,which has been used for more than 20 years.PPH has the advantages of shortening operation time,less bleeding and less postoperative pain,but also has some complications.Based on the further understanding of the pathophysiology of PPH in the treatment of prolapsed hemorrhoids,combined with the short-term and long-term curative effect,postoperative complications and technical improvement,the author understands the process of PPH production,indications,contraindications,complications,shortterm and long-term effects,as well as the technical improvement made by colorectal surgeons at home and abroad,and provides the basis for further clinical services.