While debate continues as to which is the best surgical method for the treatment of hemorrhoids, none of the currently available surgical methods approach the ideal surgical option, which is one that is effective whil...While debate continues as to which is the best surgical method for the treatment of hemorrhoids, none of the currently available surgical methods approach the ideal surgical option, which is one that is effective while being safe and painless. In reality, the less painful the procedure, the more likely it is to be associated with recurrence post-op. Where hemorrhoids surgery is concerned, there isn’t a “one size fits all” option. Most of the randomized controlled trials performed to date include hemorrhoids of various grades and with a focus on only comparing surgical methods while failing to stratify the outcomes according to the grade of hemorrhoid. We believe that surgery needs to be tailored not only to the grade of the hemorrhoids, but also to the size, circumferential nature of the disease, and prevailing symptomatology.展开更多
Hemorrhoids are considered one of the most common anorectal diseases with a prevalence of 4.4% up to 36.4% of the general population, and a peak incidence between 45 and 65 years. Hemorrhoidal disease presents with a ...Hemorrhoids are considered one of the most common anorectal diseases with a prevalence of 4.4% up to 36.4% of the general population, and a peak incidence between 45 and 65 years. Hemorrhoidal disease presents with a prolapsed lump, painless bleeding, discomfort, discharge, hygiene problems, soiling, and pruritus. Sliding anal canal lining theory is the most accepted theory as a cause of hemorrhoidal disease; however, it is also associated with hyper-vascularity, and, recently, with several enzymes or mediators involved in the disintegration of the tissues supporting the anal cushions, such as matrix metalloproteinase. A comprehensive search in published English-language literature till 2013 involving hemorrhoids was performed to construct this review article, which discusses advances in the management of hemorrhoids. This includes conservative treatment(life style modification, oral medications, and topical treatment), office procedures(rubber band ligation, injection sclerotherapy, infrared and radiofrequency coagulation, bipolar diathermy and direct-current electrotherapy, cryosurgery, and laser therapy), as well as surgical procedures including diathermy hemorrhoidectomy, Liga Sure hemorrhoidectomy, Harmonic scalpel hemorrhoidectomy, hemorrhoidal artery ligation, stapled hemorrhoidopexy(SH), and double SH. Results, merits and demerits of the different modalities of treatment of hemorrhoids are presented, in addition to the cost of the recent innovations.展开更多
目的探究超声多普勒引导下痔动脉结扎术(DG-HAL)联合吻合器痔上黏膜环切术(PPH)治疗重症痔疮的临床疗效及安全性。方法选择2016年1月-2017年1月于该院就诊的重症痔疮患者72例,按照随机数字表法分为对照组(n=35)与观察组(n=37),对照组患...目的探究超声多普勒引导下痔动脉结扎术(DG-HAL)联合吻合器痔上黏膜环切术(PPH)治疗重症痔疮的临床疗效及安全性。方法选择2016年1月-2017年1月于该院就诊的重症痔疮患者72例,按照随机数字表法分为对照组(n=35)与观察组(n=37),对照组患者接受PPH治疗,观察组接受DGHAL联合PPH治疗。观察两组患者的手术相关指标、治疗效果及并发症发生率等。结果两组患者手术时间、术中出血量无明显差异(P>0.05)。观察组术后创面愈合时间及住院时间明显短于对照组,差异有统计学意义(P<0.05)。观察组术后1个月治疗有效率为94.6%,明显高于对照组有效率77.1%,差异有统计学意义(P<0.05)。两组患者术前和术后7 d视觉模拟评分(VAS)无明显差异(P>0.05)。观察组术后14 d VAS评分明显低于对照组(P<0.05)。观察组术后3个月Wexner评分明显低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率为2.7%,明显低于对照组(P<0.05)。结论DG-HAL联合PPH治疗重症痔疮有较好的临床疗效,手术操作简单安全,术后并发症发生率低,值得临床推广使用。展开更多
文摘While debate continues as to which is the best surgical method for the treatment of hemorrhoids, none of the currently available surgical methods approach the ideal surgical option, which is one that is effective while being safe and painless. In reality, the less painful the procedure, the more likely it is to be associated with recurrence post-op. Where hemorrhoids surgery is concerned, there isn’t a “one size fits all” option. Most of the randomized controlled trials performed to date include hemorrhoids of various grades and with a focus on only comparing surgical methods while failing to stratify the outcomes according to the grade of hemorrhoid. We believe that surgery needs to be tailored not only to the grade of the hemorrhoids, but also to the size, circumferential nature of the disease, and prevailing symptomatology.
文摘Hemorrhoids are considered one of the most common anorectal diseases with a prevalence of 4.4% up to 36.4% of the general population, and a peak incidence between 45 and 65 years. Hemorrhoidal disease presents with a prolapsed lump, painless bleeding, discomfort, discharge, hygiene problems, soiling, and pruritus. Sliding anal canal lining theory is the most accepted theory as a cause of hemorrhoidal disease; however, it is also associated with hyper-vascularity, and, recently, with several enzymes or mediators involved in the disintegration of the tissues supporting the anal cushions, such as matrix metalloproteinase. A comprehensive search in published English-language literature till 2013 involving hemorrhoids was performed to construct this review article, which discusses advances in the management of hemorrhoids. This includes conservative treatment(life style modification, oral medications, and topical treatment), office procedures(rubber band ligation, injection sclerotherapy, infrared and radiofrequency coagulation, bipolar diathermy and direct-current electrotherapy, cryosurgery, and laser therapy), as well as surgical procedures including diathermy hemorrhoidectomy, Liga Sure hemorrhoidectomy, Harmonic scalpel hemorrhoidectomy, hemorrhoidal artery ligation, stapled hemorrhoidopexy(SH), and double SH. Results, merits and demerits of the different modalities of treatment of hemorrhoids are presented, in addition to the cost of the recent innovations.
文摘目的探究超声多普勒引导下痔动脉结扎术(DG-HAL)联合吻合器痔上黏膜环切术(PPH)治疗重症痔疮的临床疗效及安全性。方法选择2016年1月-2017年1月于该院就诊的重症痔疮患者72例,按照随机数字表法分为对照组(n=35)与观察组(n=37),对照组患者接受PPH治疗,观察组接受DGHAL联合PPH治疗。观察两组患者的手术相关指标、治疗效果及并发症发生率等。结果两组患者手术时间、术中出血量无明显差异(P>0.05)。观察组术后创面愈合时间及住院时间明显短于对照组,差异有统计学意义(P<0.05)。观察组术后1个月治疗有效率为94.6%,明显高于对照组有效率77.1%,差异有统计学意义(P<0.05)。两组患者术前和术后7 d视觉模拟评分(VAS)无明显差异(P>0.05)。观察组术后14 d VAS评分明显低于对照组(P<0.05)。观察组术后3个月Wexner评分明显低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率为2.7%,明显低于对照组(P<0.05)。结论DG-HAL联合PPH治疗重症痔疮有较好的临床疗效,手术操作简单安全,术后并发症发生率低,值得临床推广使用。
