Background: Procedure for prolapse and hemorrhoids (PPH) has emerged as an alternative surgical treatment of symptomatic hemorrhoids. The operative technique along with the device to be used is constantly evolving. Ai...Background: Procedure for prolapse and hemorrhoids (PPH) has emerged as an alternative surgical treatment of symptomatic hemorrhoids. The operative technique along with the device to be used is constantly evolving. Aim: The aim of the present study was to evaluate results of PPH using a modified technique and an innovative circular stapler. Material and Methods: A prospective, comparative study of patients undergoing PPH for symptomatic Grade II and Grade III internal hemorrhoids with either 32 mm or 34 mm stapler diameter (Circular Stapler for Hemorrhoids-CSH 32/34) during a 36 month period (1/1/2012-1/1/2015) was performed. A modified operative technique using two purse string sutures was employed. Patients were evaluated and compared in terms of postoperative complications, operation time, length of hospital stay and time to return to normal activities. Results: A total of 100 patients were included: 50 in the CSH 32 group and 50 in the CSH 34 group. Complication rates were equal for both stapler diameters (32 mm and 34 mm). Serious or life threatening complications were not encountered and need for reintervention was never met. Operation time, length of hospital stay and time to return to normal activities were similar in both groups. Conclusions: Our study suggests that there are no significant differences between the two available diameters of a new-fangled circular stapler, using a modified technique. It seems that progress of hemorrhoidal staplers has led to a step towards the goals of implement and from then on complications of surgical practice could be merely a matter of operative technique.展开更多
Objective:To explore the effect of moxibustion for preventing post-hemorrhoidectomy urinary retention of mixed hemorrhoids.Design:Two-arm randomized clinical trial with blinded outcome assessment and statistician.Sett...Objective:To explore the effect of moxibustion for preventing post-hemorrhoidectomy urinary retention of mixed hemorrhoids.Design:Two-arm randomized clinical trial with blinded outcome assessment and statistician.Setting:Anorectal Department of Changshu Affiliated Hospital of Nanjing University of Chinese Medicine,from October 2020 to a cutoff day in March 2021.Participants:120 patients with mixed hemorrhoids undertaken hemorrhoidectomy.Interventions:In the moxibustion group,moxibustion was exerted after surgery at Zhongji(CV3),Qihai(CV6),Guanyuan(CV4)and Sanyinjiao(SP6,bilateral).In the medication group,tamsulosin was administered orally after surgery.The cases were all observed for 24 h in two groups.Outcome measures:The primary outcome was incidence of post-hemorrhoidectomy urinary retention and the secondary outcomes included time to the first voiding,the first voiding volume and adverse events were measured and compared between two groups.Results:Sixty patients in each group were included in the data analysis and no change was made to the design of the trial after the trial begun.After treatment,the incidence of the post-hemorrhoidectomy urinary retention was 5%in the moxibustion group,lower than 20%in the medication group(P<0.05).The time to the first voiding after surgery was(4.76±1.69)h in the moxibustion group,shorter than(6.81±1.15)h in the medication group(P<0.05).The first voiding volume in the moxibustion group was(300.67±110.33)mL,higher than(224.67±90.88)mL in the medication group(P<0.05).There was no adverse event during study in the moxibustion group.Dizziness and nausea occurred in the medication group.Conclusion:Moxibustion reduced the incidence of post-hemorrhoidectomy urinary retention,shortened the time to the first voiding and improved the urine volume after hemorrhoidectomy of mixed hemorroids.This therapy could be beneficial and safe,and thus could be recommended to the clinical practice.展开更多
文摘Background: Procedure for prolapse and hemorrhoids (PPH) has emerged as an alternative surgical treatment of symptomatic hemorrhoids. The operative technique along with the device to be used is constantly evolving. Aim: The aim of the present study was to evaluate results of PPH using a modified technique and an innovative circular stapler. Material and Methods: A prospective, comparative study of patients undergoing PPH for symptomatic Grade II and Grade III internal hemorrhoids with either 32 mm or 34 mm stapler diameter (Circular Stapler for Hemorrhoids-CSH 32/34) during a 36 month period (1/1/2012-1/1/2015) was performed. A modified operative technique using two purse string sutures was employed. Patients were evaluated and compared in terms of postoperative complications, operation time, length of hospital stay and time to return to normal activities. Results: A total of 100 patients were included: 50 in the CSH 32 group and 50 in the CSH 34 group. Complication rates were equal for both stapler diameters (32 mm and 34 mm). Serious or life threatening complications were not encountered and need for reintervention was never met. Operation time, length of hospital stay and time to return to normal activities were similar in both groups. Conclusions: Our study suggests that there are no significant differences between the two available diameters of a new-fangled circular stapler, using a modified technique. It seems that progress of hemorrhoidal staplers has led to a step towards the goals of implement and from then on complications of surgical practice could be merely a matter of operative technique.
基金Supported by Suzhou Special Project of the Clinical Diagnosis and Treatment Technology for Major Diseases:LCZX202022Science and Technology Planning Project of Changshu Municipal Health Commission:CSWSQ202108+1 种基金supported by Changshu Health Commission Science and Technology Plan Project(CSWSQ202108)Suzhou ClinicalKey Disease Diagnosis and Treatment Technology Special Project(LCZX202022)。
文摘Objective:To explore the effect of moxibustion for preventing post-hemorrhoidectomy urinary retention of mixed hemorrhoids.Design:Two-arm randomized clinical trial with blinded outcome assessment and statistician.Setting:Anorectal Department of Changshu Affiliated Hospital of Nanjing University of Chinese Medicine,from October 2020 to a cutoff day in March 2021.Participants:120 patients with mixed hemorrhoids undertaken hemorrhoidectomy.Interventions:In the moxibustion group,moxibustion was exerted after surgery at Zhongji(CV3),Qihai(CV6),Guanyuan(CV4)and Sanyinjiao(SP6,bilateral).In the medication group,tamsulosin was administered orally after surgery.The cases were all observed for 24 h in two groups.Outcome measures:The primary outcome was incidence of post-hemorrhoidectomy urinary retention and the secondary outcomes included time to the first voiding,the first voiding volume and adverse events were measured and compared between two groups.Results:Sixty patients in each group were included in the data analysis and no change was made to the design of the trial after the trial begun.After treatment,the incidence of the post-hemorrhoidectomy urinary retention was 5%in the moxibustion group,lower than 20%in the medication group(P<0.05).The time to the first voiding after surgery was(4.76±1.69)h in the moxibustion group,shorter than(6.81±1.15)h in the medication group(P<0.05).The first voiding volume in the moxibustion group was(300.67±110.33)mL,higher than(224.67±90.88)mL in the medication group(P<0.05).There was no adverse event during study in the moxibustion group.Dizziness and nausea occurred in the medication group.Conclusion:Moxibustion reduced the incidence of post-hemorrhoidectomy urinary retention,shortened the time to the first voiding and improved the urine volume after hemorrhoidectomy of mixed hemorroids.This therapy could be beneficial and safe,and thus could be recommended to the clinical practice.
