直肠黏膜环切吻合肛垫悬吊治疗重度痔

目的 探讨使用吻合器行直肠痔上黏膜环切吻合肛垫悬吊术(PPH)的效果和可行性。方法 使用PPH吻合器治疗Ⅲ-Ⅳ度痔74例,其中男27例,女47例,平均年龄57岁(31—80岁),平均发病时间7．3年,最长30年。结果 72例患者术后2～3d脱出痔完全回缩,2例患者因术中行肛门息肉切除,术后出现疼痛和肛门水肿,1周后水肿消失疼痛好转。3例患者发生术中和术后出血,其中1例痔急性水肿期术后出血,2例因吻合器故障出现吻合和切割不全,出血较多约300ml,手术时间延长至1h。70例患者手术时间约为10—15min。除2例患者住院时间超过1周外,大多患者住院时间为2～4d。结论 PPH技术治疗Ⅲ-Ⅳ度痔效果好安全可靠,手术和住院时间短,术后基本无疼痛。

Treatment of prolapsed hemorrhoids with circular stapler

OBJECTIVE: To evaluate the efficacy and safety of circumferential mucosectomy procedure for treatment of prolapsed hemorrhoids (PPH). METHODS: From June 2001 to June 2003, 74 patients (27 men and 47 women) with an average age of 57 years (ranging from 31 to 80 years), with prolapsed hemorrhoids III - IV degree underwent PPH using a circular stapler. RESULTS: 69 (93.2%) patients were fully satisfied with results. Two patients underwent simultaneous rectal polypectomy along with PPH hence required analgesic treatment for 5 days. Three patients experienced bleeding during or after operation, 1 case bleeding was due to ulcerative hemorrhoid, while the bleeding the remaining 2 cases was (bleeding about 300 ml) caused by insufficient anastomosis, thus extending operating time to 1 hour. The average operation time (70 patients) was 13 minutes (range 10 - 15 minutes). The mean hospitalization was 3.5 days (2 - 4 days), with exception of 2 patients lasting 1 week. CONCLUSION: PPH is a safe, effective and rapid method for treatment of prolapsed hemorrhoids, The procedure causes minimal pain with decreased complications.