大视窗吻合器联合肛管上皮保留术治疗环状混合痔的回顾性队列研究  

Retrospective cohort study of TST-MS combined with anal canal epithelial preservation operation in the treatment of circular mixed hemorrhoids

作　　者：黄华[1] 谷云飞 卫军 赵平[1] 季利江[1] HUANG Hua;GU Yunfei;WEI Jun;ZHAO Ping;JI Lijiang(Department of Anorectal,Changshu Hospital Affiliated to Nanjing University of Chinese Medicine,Changshu 215500,China)

机构地区：[1]南京中医药大学常熟附属医院肛肠科,江苏常熟215500 [2]南京中医药大学附属医院肛肠科,江苏南京210000

出　　处：《皖南医学院学报》2023年第3期255-258,共4页Journal of Wannan Medical College

基　　金：苏州市临床重点病种诊疗技术专项项目(LCZX202022);苏州市科技发展计划医疗卫生科技创新项目(SKY2022018);常熟市卫健委青年项目(CSWSQ202007);常熟市科技局重点资助项目(CS201925)。

摘　　要：目的:探讨大视窗吻合器联合肛管上皮保留术治疗环状混合痔的临床应用价值及安全性。方法:采用回顾性队列研究的方式,纳入2019年7月~2020年12月患者,研究组159例,对照组137例。研究组采用大视窗吻合器(TST-MS)联合肛管上皮保留术,对照组采用吻合器痔上黏膜环切术(PPH)联合外痔切除术,随访1年。结果:研究组累计复发率及外痔残留率低于对照组(P<0.01)。研究组的肛门水肿及肛门失禁发生率更低(P<0.01)。研究组的标本质量及体积更大(P<0.01),且标本带有肌层比例更高(P<0.001)。研究组复发患者年龄更大,病程更长,切除标本体积更小(均P<0.05)。结论:TST-MS术联合肛管上皮保留术治疗环状混合痔复发率低,并发症少,对肛门功能保护良好,值得临床推广应用。Objective:To investigate the clinical value and safety of tissue selecting technique with mega-window stapler(TST-MS)combined with anal canal epithelial preservation operation in the treatment of circular mixed hemorrhoids.Methods:Retrospective cohort study was conducted in 159 patients included from July 2019 to December 2020 in the observational group,and another 137 patients were recruited as control group.Patients in the observational group were treated by TST-MS combined with anal canal epithelial preservation operation,and those in the control group underwent procedure for prolapse and hemorrhoids(PPH)combined with external hemorrhoidectomy.Patients in both groups were followed up for one year.Results:The cumulative recurrence rate and residual rate of external hemorrhoids in the observational group were lower than those in the control group(P<0.01).Patients in the observational group had much lower incidence of anal edema and incontinence,and larger weight and volume of specimens removed in the procedure as well as higher proportion of specimens with muscle layer(P<0.01).Additionally,the patients were older in recurrent age,the course of disease was longer,and the volume of resected specimens was smaller in the observational group(P<0.05).Conclusion:TST-MS with anal canal epithelial preservation operation in the treatment of circular mixed hemorrhoids is worthy of clinical recommendation,for it has low recurrence rate,fewer complications and better protection of anal function.

关 键 词：大视窗吻合器 肛管上皮保留术 环状混合痔 回顾性 

分 类 号：R657.18[医药卫生—外科学]