【评论】LigaSure痔切除术与传统Milligan-Morgan术在尼日利亚Ⅲ/Ⅳ度痔病患者中的对比分析  

Comment]LigaSure versus conventional Milligan Morgan hemorrhoidectomy in Nigerian patients with symptomatic hemorrhoids

作　　者：黄鉴[1] Huang Jian

机构地区：[1]昆明医科大学第一附属医院肿瘤外科,云南昆明650000

出　　处：《结直肠肛门外科》2025年第1期68-69,共2页Journal of Colorectal & Anal Surgery

摘　　要：背景痔切除术被认为是治疗Ⅲ度和Ⅳ度痔病患者最有效的方法,手术过程可能会伴有术后疼痛或其他并发症。一些手术技术和设备已经被设计来克服这些问题。目的比较尼日利亚有症状痔患者接受LigaSure痔切除术与传统Milligan-Morgan术的围手术期和术后疗效。方法所有符合纳入标准的成年患者被随机分配,分别接受传统Milligan-Morgan术或LigaSure痔切除术。结果测量指标包括手术时间、估计失血量和症状缓解情况,使用索德格林痔病严重程度评分进行评估。术后疼痛情况使用视觉模拟评分法进行评估,并在术后3个月评价短期复发率。结果52例患者被平均随机分配到Milligan-Morgan组和LigaSure组。LigaSure组的中位失血量为10.0 mL,而Milligan Morgan组的中位失血量为26.5 mL(P=0.0001)。LigaSure组术后2周的中位视觉模拟评分为5.5分,Milligan-Morgan组为6.0分(P=0.002)。LigaSure组的平均手术时间为18.04 min,Milligan-Morgan组为34.19 min(P=0.0001)。结论与传统Milligan-Morgan术相比,LigaSure痔切除术手术时间更短,且术中失血量更少。Background Hemorrhoidectomy is considered as the most effective approach for patients with gradeⅢand gradeⅣhemorrhoids;the operative procedure may be associated with significant postoperative pain and other complications.Several surgical techniques and devices have been developed to overcome these postoperative problems.Objective To compare perioperative and postoperative outcomes of hemorrhoidectomy performed with the LigaSure and the conventional Milligan-Morgan hemorrhoidectomy among Nigerian patients with symptomatic hemorrhoids.Methodology All consenting adult patients who fulfilled the inclusion criteria were randomized to either conventional Milligan-Morgan or LigaSure hemorrhoidectomy.Outcome measures were the duration of the procedure,estimated blood loss,and resolution of symptoms,which were assessed using the Sodergren hemorrhoids severity score(SHSS).Postoperative pain was evaluated using the visual analog scale(VAS),and the short-term recurrence rate was also checked at 3 months.Data were analyzed using the computer software IBM SPSS version 23.Results Fifty-two patients were randomized equally into the two arms.The median blood loss in the LigaSure group was 10.0 mL,whereas the median blood loss in the Milligan-Morgan group was 26.5 mL,(P=0.0001).The median postoperative pain at 2 weeks using the VAS was 5.5 in the LigaSure group,and in the Milligan-Morgan group,it was 6.0(P=0.002).The mean duration of surgery in the LigaSure group was 18.04 min and 34.19 min in the Milligan-Morgan group(P=0.0001).Conclusion LigaSure hemorrhoidectomy is faster and associated with less blood loss compared to conventional Milligan-Morgan hemorrhoidectomy.

关 键 词：痔病 LIGASURE 痔切除术 

分 类 号：R657.18[医药卫生—外科学]