Modified procedure for prolapse and hemorrhoids: Lower recurrence, higher satisfaction  

作　　者：Yan-Yu Chen Yi-Fan Cheng Quan-Peng Wang Bo Ye Chong-Jie Huang Chong-Jun Zhou Mao Cai Yun-KuiYe Chang-Bao Liu 

机构地区：[1]Department of Anorectal Surgery,The 2^nd Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University,Wenzhou 325000,Zhejiang Province,China [2]Department of Biostatistics,School of Public Health,State University of New York at Albany,Albany,NY 12206,United States

出　　处：《World Journal of Clinical Cases》2021年第1期36-46,共11页世界临床病例杂志

摘　　要：BACKGROUND Hemorrhoidal prolapse is a common benign disease with a high incidence.The treatment procedure for prolapse and hemorrhoids(PPH)remains an operative method used for internal hemorrhoid prolapse.Although it is related to less posoperative pain,faster recovery and shorter hospital stays,the postoperative recurrence rate is higher than that of the Milligan-Morgan hemorrhoidectomy(MMH).We have considered that recurrence could be due to shortage of the pulling-up effect.This issue may be overcome by using lower purse-string sutures[modified-PPH(M-PPH)].AIM To compare the therapeutic effects and the patients’satisfaction after M-PPH,PPH and MMH.METHODS This retrospective cohort study included 1163 patients(M-PPH,461;original PPH,321;MMH,381)with severe hemorrhoids(stage III/IV)who were admitted to The 2nd Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University from 2012 to 2014.Early postoperative complications,efficacy,postoperative anal dysfunction and patient satisfaction were compared among the three groups.Established criteria were used to assess short-and long-term postoperative complications.A visual analog scale was used to evaluate postoperative pain.Follow-up was conducted 5 years postoperatively.RESULT Length of hospital stay and operating time were significantly longer in the MMH group(8.05±2.50 d,19.98±4.21 min;P<0.0001)than in other groups.The incidence of postoperative anastomotic bleeding was significantly lower after MPPH than after PPH or MMH(1.9%,5.1%and 3.7%;n=9,16 and 14;respectively).There was a significantly higher rate of sensation of rectal tenesmus after M-PPH than after MMH or PPH(15%,8%and 10%;n=69,30 and 32;respectively).There was a significantly lower rate of recurrence after M-PPH than after PPH(8.7%and 18.8%,n=40 and 61;P<0.0001).The incidence of postoperative anal incontinence differed significantly only between the MMH and M-PPH groups(1.3%and 4.3%,n=5 and 20;P=0.04).Patient satisfaction was significantly greater after M-PPH than after other su

关 键 词：HEMORRHOIDS Milligan-Morgan hemorrhoidectomy Postoperative complications Procedure for prolapse and hemorrhoids RECURRENCE Patient satisfaction 

分 类 号：R657.18[医药卫生—外科学]