PURPOSE: Perioperative morbidity and long- term results after hemorrhoidectomy (Ferguson’ s technique) were evaluated as a basis for comparison with new methods such as stapled hemorrhoidectomy. METHODS: All records ...PURPOSE: Perioperative morbidity and long- term results after hemorrhoidectomy (Ferguson’ s technique) were evaluated as a basis for comparison with new methods such as stapled hemorrhoidectomy. METHODS: All records of patients who underwent conventional hemorrhoidectomy between January 1, 1993 and December 31, 1997 (five years) were retrospectively analyzed. The surgical technique was Ferguson closed hemorrhoidectomy. Long- term results were evaluated with a standardized questionnaire that was sent to all patients. RESULTS: Five- hundred- fourteen patients (195 female, 319 male) with a mean age of 52 (range, 22- 96) years were evaluated. Postoperatively, seven patients had a relevant hemorrhage, and two had to undergo reoperation (reoperation rate within 30 days, 0.4 percent). In 15 cases (3 percent) patients received urinary catheters for postoperative urinary retention. Mortality was 0 percent. The questionnaire was returned by 403 patients (78.4 percent). The mean follow- up was 4.7 (range, 2.1- 7.8) years. The leading symptom was relieved in 275 patients (67.4 percent), ameliorated in 111 (27.2 percent), and unchanged or worse in 22 (5.4 percent). Incontinence (soiling) was not present in 291 (71.7 percent) patients, light in 86 (21.2 percent), moderate in 25 (6.1 percent), and severe in 4 (0.98 percent). Reoperation rate for recurrent hemorrhoids was 0.8 percent. Patients evaluated the surgical result as excellent in 286 (70.5 percent) cases, good in 87 (21.4 percent), moderate in 25 (6.2 percent), and bad in 8 (1.9 percent) cases. CONCLUSION: Ferguson closed hemorrhoidectomy results in very low rates of perioperative morbidity. Long- term results demonstrate high patient satisfaction and low incontinence and reoperation rates. It could be the gold standard to which other techniques are compared.展开更多
痔疮是最为常见的肛肠疾病之一,其发病率高、病程长。针对Ⅲ~Ⅳ度症状严重的中重度混合痔,临床上常采用痔上黏膜环切术(procedure for pro⁃lapse and hemorrhoids,PPH)联合传统外剥内扎术(milligan-Morgan hemorrhoidectomy,MMH),其临...痔疮是最为常见的肛肠疾病之一,其发病率高、病程长。针对Ⅲ~Ⅳ度症状严重的中重度混合痔,临床上常采用痔上黏膜环切术(procedure for pro⁃lapse and hemorrhoids,PPH)联合传统外剥内扎术(milligan-Morgan hemorrhoidectomy,MMH),其临床效果好、术后复发率低,但术后常并发疼痛、出血、肛门水肿、创面渗出物增多、肛管狭窄、切口愈合延迟等并发症[1-2]。展开更多
目的分析探究痔疮合并直肠脱垂患者采用吻合器痔上黏膜环状切除术(Procedure for prolapse and hemorrhoids,PPH)方式的应用价值,以期指导临床术式选择。方法将纳入研究的62例痔疮合并直肠脱垂患者研究对象依据手术方式分为PPH组和传统...目的分析探究痔疮合并直肠脱垂患者采用吻合器痔上黏膜环状切除术(Procedure for prolapse and hemorrhoids,PPH)方式的应用价值,以期指导临床术式选择。方法将纳入研究的62例痔疮合并直肠脱垂患者研究对象依据手术方式分为PPH组和传统手术组,PPH组27例痔疮合并直肠脱垂患者应用PPH方式治疗,传统手术组35例痔疮合并直肠脱垂患者应用传统外剥内扎术治疗,对比两组患者治疗情况。结果PPH组27例痔疮合并直肠脱垂患者临床总有效人数为24例,占比88.9%,明显高于传统手术组(χ^(2)=5.395,P=0.020<0.05)。与传统手术组比,PPH组27例患者手术24 h内、手术1周后以及术后第一次排便时的疼痛评分情况均明显偏低(P<0.05)。PPH组27例痔疮合并直肠脱垂患者不良结局发生总人数为2例,占比7.4%,明显低于传统手术组(χ^(2)=6.299,P=0.012<0.05)。结论PPH用于痔疮合并直肠脱垂治疗,可减轻患者疼痛程度,改善肛门功能,降低术后不良结局的发生。展开更多
文摘PURPOSE: Perioperative morbidity and long- term results after hemorrhoidectomy (Ferguson’ s technique) were evaluated as a basis for comparison with new methods such as stapled hemorrhoidectomy. METHODS: All records of patients who underwent conventional hemorrhoidectomy between January 1, 1993 and December 31, 1997 (five years) were retrospectively analyzed. The surgical technique was Ferguson closed hemorrhoidectomy. Long- term results were evaluated with a standardized questionnaire that was sent to all patients. RESULTS: Five- hundred- fourteen patients (195 female, 319 male) with a mean age of 52 (range, 22- 96) years were evaluated. Postoperatively, seven patients had a relevant hemorrhage, and two had to undergo reoperation (reoperation rate within 30 days, 0.4 percent). In 15 cases (3 percent) patients received urinary catheters for postoperative urinary retention. Mortality was 0 percent. The questionnaire was returned by 403 patients (78.4 percent). The mean follow- up was 4.7 (range, 2.1- 7.8) years. The leading symptom was relieved in 275 patients (67.4 percent), ameliorated in 111 (27.2 percent), and unchanged or worse in 22 (5.4 percent). Incontinence (soiling) was not present in 291 (71.7 percent) patients, light in 86 (21.2 percent), moderate in 25 (6.1 percent), and severe in 4 (0.98 percent). Reoperation rate for recurrent hemorrhoids was 0.8 percent. Patients evaluated the surgical result as excellent in 286 (70.5 percent) cases, good in 87 (21.4 percent), moderate in 25 (6.2 percent), and bad in 8 (1.9 percent) cases. CONCLUSION: Ferguson closed hemorrhoidectomy results in very low rates of perioperative morbidity. Long- term results demonstrate high patient satisfaction and low incontinence and reoperation rates. It could be the gold standard to which other techniques are compared.
文摘痔疮是最为常见的肛肠疾病之一,其发病率高、病程长。针对Ⅲ~Ⅳ度症状严重的中重度混合痔,临床上常采用痔上黏膜环切术(procedure for pro⁃lapse and hemorrhoids,PPH)联合传统外剥内扎术(milligan-Morgan hemorrhoidectomy,MMH),其临床效果好、术后复发率低,但术后常并发疼痛、出血、肛门水肿、创面渗出物增多、肛管狭窄、切口愈合延迟等并发症[1-2]。
文摘目的分析探究痔疮合并直肠脱垂患者采用吻合器痔上黏膜环状切除术(Procedure for prolapse and hemorrhoids,PPH)方式的应用价值,以期指导临床术式选择。方法将纳入研究的62例痔疮合并直肠脱垂患者研究对象依据手术方式分为PPH组和传统手术组,PPH组27例痔疮合并直肠脱垂患者应用PPH方式治疗,传统手术组35例痔疮合并直肠脱垂患者应用传统外剥内扎术治疗,对比两组患者治疗情况。结果PPH组27例痔疮合并直肠脱垂患者临床总有效人数为24例,占比88.9%,明显高于传统手术组(χ^(2)=5.395,P=0.020<0.05)。与传统手术组比,PPH组27例患者手术24 h内、手术1周后以及术后第一次排便时的疼痛评分情况均明显偏低(P<0.05)。PPH组27例痔疮合并直肠脱垂患者不良结局发生总人数为2例,占比7.4%,明显低于传统手术组(χ^(2)=6.299,P=0.012<0.05)。结论PPH用于痔疮合并直肠脱垂治疗,可减轻患者疼痛程度,改善肛门功能,降低术后不良结局的发生。
