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排序方式: 共有121条查询结果,搜索用时 15 毫秒
1.
Treatment of Hemorrhoids in Day Surgery: Stapled Hemorrhoidopexy vs Milligan–Morgan Hemorrhoidectomy
Vito Maria Stolfi Pierpaolo Sileri Chiara Micossi Isabella Carbonaro Marco Venza Paolo Gentileschi Piero Rossi Alessandro Falchetti Achille Gaspari 《Journal of gastrointestinal surgery》2008,12(5):795-801
Background Recently, it has been demonstrated that surgical treatment of hemorrhoids in a day-care basis is possible and safe. The aim
of this study was to compare the Longo stapled hemorrhoidopexy (SH) and the Milligan–Morgan hemorrhoidectomy (MMH).
Methods One hundred seventy one patients (95 cases in SH group and 76 cases in MMH group) entered the study: 83 cases were III degree
hemorrhoids, 88 IV degree. A priori and a post hoc power analysis were performed. Results, prospectively collected, were compared
using chi squared test and student t test. Visual analog scale was used for pain evaluation. Postoperative pain, duration of pain, wound secretion, bleeding,
resumption of a normal lifestyle, and postoperative complication were evaluated.
Results Surgical time was 28.41 ± 10.78 for MMH and 28.30 ± 13.28 min in SH (P = 0.94). Postoperative pain was not different between MMH and SH during the first two postoperative days (4.73 ± 2.91 vs
5.1 ± 3.048; P = 0.4), during the following 6 days, patients treated with SH had less pain (4.63 ± 2.04 in MMH vs 3.60 ± 2.35 in SH; P = 0.006). In the SH group, seven patients needed further hospital stay for complicated course. SH showed higher incidence
of anal fissure compared with MMH (6.3% vs 0%; P = 0.025) but no differences in urinary retention, anal stricture, urgency, or anal hemorrhage.
Conclusions This study confirms that SH is associated with less postoperative pain and shorter postoperative symptoms, compared with MMH.
SH may be a viable addition to the therapy for hemorrhoids with some advantages in early postoperative pain and some disadvantages
in postoperative complications and costs. 相似文献
2.
Active drains, which work by negative pressure, require a closed space for retaining the vacuum. Here the authors describe their novel technique of combining a J-Vac® drain and the sponge of a vacuum assisted closure dressing pack to drain a rectal wound. This modification may be useful for rectal wounds and anastomotic leaks. 相似文献
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目的:评价三角吻合术在微创食管切除、食管胃颈部吻合术中应用的安全性和有效性。方法回顾性分析2013年1月至2014年3月在复旦大学附属中山医院胸外科接受胸腹腔镜食管癌根治切除加食管胃颈部吻合术的137例患者的临床资料,其中三角吻合77例(三角吻合组),管状吻合60例(管状吻合组)。结果三角吻合组和管状吻合组术中吻合时间分别为(18.0±3.9) min 和(17.0±2.9) min,差异无统计学意义(P=0.099);术后吻合口瘘发生率分别为3.9%(3/77)和10.0%(6/60),差异无统计学差异(P=0.152);吻合口狭窄发生率分别为1.3%(1/77)和15.0%(9/60),差异有统计学意义(P=0.002)。两组患者在围手术期死亡率、心血管并发症、肺部并发症等方面的差异均无统计学意义(P>0.05)。结论颈部三角吻合术是一种安全、有效的吻合方法,可以降低术后吻合口狭窄的发生。 相似文献
6.
Paul H. Sugarbaker 《Journal of surgical oncology》1996,61(2):155-158
Low anastomosis using a circular stapling instrument has become standard for performing a colorectal reconstruction following resection of a rectal cancer. Often these anastomoses are performed deep in the pelvis using a circular stapling instrument without clear visualization of the anastomotic site. In the female patient, unless an adequate stump of rectum is left above the circular staple line, there is danger that the side wall of the posterior aspect of the vagina can be included in the tissue rings (donuts) that are resected by the circular stapling instrument. This leaves the patient at high risk for late development of a rectovaginal fistula by vaginal mucosa being incorporated into the rectal wall. Maintenance of an adequate stump beyond the linear staple line and a vaginal examination prior to firing the circular stapler will prevent this problem. A patient is presented and the technical details for a safe low-low colorectal anastomosis are reviewed. © 1996 Wiley-Liss, Inc. 相似文献
7.
A. R. Naylor 《Acta chirurgica Belgica》2013,113(1):44-46
Purpose: To compare the postoperative evolution and the long-term efficacy after stapled haemorrhoidopexy (PPH) and Milligan-Morgan haemorrhoidectomy (MM).Methods: In a prospective randomized study, 40 patients requiring surgical treatment for prolapsing haemorrhoids grade II or III were assigned to either MM or PPH (20 each). Postoperative pain, wound healing were evaluated, as well as anal pressures and sphincter anatomy. Mean follow-up is 46 months.Results: Postoperative pain at rest and during defecation was less important after PPH if no resection of external piles or skin tags was associated (P < 0.0001). Healing time was shorter after PPH (P < 0.0001). Endoanal ultrasound remained unchanged postoperatively. Resting and squeeze pressures decreased after MM, but not after PPH (P < 0.01). After a mean follow-up of 46 months (12-56), persistent or recurrent symptoms, mostly mild and temporary, were observed after both MM and PPH, in 7 and 11 patients respectively (NS). After PPH, five patients (25%) complained of recurrent external swelling and/or prolapse (P = 0.047 vs. MM) requiring redo surgery in four of them, after 10, 13, 14 and 21 months. No redo-surgery was required after MM. Long term patient satisfaction after PPH was not better than after MM.Conclusions: Postoperative pain is less important after PPH. This advantage disappears if any resection is associated with the stapling. At medium to long-term follow-up, PPH seems to carry a higher risk of symptomatic external haem-orrhoidal disease, needing further surgery. 相似文献
8.
BACKGROUND: Single-stapled double-pursestring technique for colorectal anastomosis to the mid-rectum or upper rectum is the most commonly used technique in the single institution reported here. The investigators evaluate single-stapled double-pursestring anastomosis after anterior resection of the rectum performed at a single institution. METHODS: Medical records of patients who underwent single-stapled double-pursestring anastomosis between January 2000 and May 2005 were analyzed to identify postoperative anastomotic complications. Patients with previous radiation, diverting stoma, coloanal, and hand-sewn and double-stapled anastomoses were excluded. The primary goal was to identify postoperative anastomotic complications. RESULTS: Of 160 patients, 153 (96%) no septic complications. One patient (.6%) developed anastomotic leak requiring diversion. Of the 4 patients with pelvic abscesses (2.5%), 2 were treated with antibiotics and 2 with computed axial tomography-guided drainage. CONCLUSIONS: Single-stapled double-pursestring anastomosis is reliable, with very low rates of leak, subsequent diversion, and pelvic abscess (.6%, .6%, and 2.5% respectively). 相似文献
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