ABSTRACT
Circumferential mixed hemorrhoids are very difficult to treat non-surgically. Therefore, it is important to explore the surgical methods for its complete resolution as well as maintenance of normal anal anatomy and function. The present study was designed to evaluate the effect of segmented and plastic hemorrhoidectomy (SPH) on patients with circumferential mixed hemorrhoids. A total of 300 patients with circumferential mixed hemorrhoids were divided into experimental group (n=150) undergoing SPH and control group (n=150) undergoing Milligan-Morgan hemorrhoidectomy. There were no differences in cure and effectiveness rates between two groups. Compared with the control group, patients in the experimental group had shorter healing time (15.7±1.3 vs 12.5±0.7 days) and recovery to normal activity (18.5±2.7 vs 14.7±1.2 days). In addition, anal function of all patients in the experimental group was normal during short- and long-term follow-up. However, more cases in the control group showed anal dampness and itching, and poor control of intestinal liquid. Compared with the control group, patients in the experimental group had better outcomes in overall anal function and smoothness at 6, 12, and 18 months after operation as well as patient satisfaction. Furthermore, the rating in the visual analogue scale for defecation pain and edema in the experimental group was less than that in the control group. SPH was more effective, had fewer complications, better protection of anal function, and a better cosmetic result.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Hemorrhoids/surgery , Postoperative Complications , Severity of Illness Index , Case-Control Studies , Single-Blind Method , Follow-Up Studies , Treatment Outcome , Patient SatisfactionABSTRACT
Objective To observe the effect of segmented external dissection and internal ligation and leather bridge ligation plastic surgery in treatment of circumferential mixed hemorrhoids. Methods One hundred and twenty patients with circumferential mixed hemorrhoids were enrolled in this study, and they were divided into observation group and control group according to operation methods, with 60 cases in each group. The patients in two groups were treated with segmented Milligan-Morgan. The patients in observation group were treated with leather bridge ligation plastic surgery, and the patients in control group were treated with slit skin bridge plastic surgery. Postoperative complications and effect were observed. Results The pain scores on the first day and the third day after operation in two groups had no significant differences (P>0.05). On the seventh day after operation, the pain scores in observation group was significantly better than that in control group (P 0.05). The number of broken leather bridge in observation group was significantly shorter than that in control group (P<0.01). The healing time in the observation group was significantly shorter than that in control group:(24.0 ± 3.6) d vs. (29.6 ± 4.70) d, t =- 6.05, P<0.01. Conclusions Segmented external dissection and internal ligation and leather bridge ligation plastic surgery in treatment of circumferential mixed hemorrhoids is safe and easy to operate, and it has a significant clinical effect.
ABSTRACT
This study was aimed to compare clinical effect and safety of ring mixed hemorrhoids treatment with pro-cedure for prolapsed and hemorrhoids (PPH) and Milligan-Morgan (M-M) in order to evaluate their effects of health economics. Retrospective analysis was given on clinical data of 100 cases (including 48 cases in P group, 52 cases in M group) which met the inclusion criteria from June 2008 to June 2010 in the Affiliated Hospital of Luzhou Med-ical College. Statistical analysis was made on short- and long-term effect, patient satisfaction, perioperative and postoperative complications of two groups. The cost-effectiveness was analyzed with the effect of health economics methods. The results showed that there was no obvious difference on short-term effect between two groups. However, aspects such as surgery time, hospitalization time, back to work time, duration of pain, bleeding condition, postopera-tive pain and anal swelling in P group were significantly better than M group (P< 0.05); long-term effect and cost-effectiveness in M group were obviously better than P group (P < 0.05). There was no obvious difference on inci-dence rate of adverse reaction between two groups. It was concluded that the traditional external dissection and inter-nal ligation for circumferential mixed hemorrhoids had better clinical effect of both short- and long-term with better cost-effectiveness. It is still a better surgical treatment for circular mixed hemorrhoids.
ABSTRACT
Objective To compare the clinical outcome of procedure for prolapse and hemorrhoids (PPH) and PPH + selective Milligan-Morgan hemorrhoidectomy(MMH) in surgical treatment of Ⅲ ～ Ⅳ stage hemorrhoids and research the best surgical procedures.Methods Retrospective analysis was made on the clinical data of 125 cases with Ⅲ ～ Ⅳ stage mixed hemorrhoids,they were non-randomized-controlled divided into PPH group (group 1) and PPH + selective MMH group(group 2),comparing the data of recurrence,complication and symptoms relief including anal prolapse,bleeding,anus fall feeling,wet anus and pruritus ani.Results While observing 3 years after operation,group 1 and group 2 both relieved symptoms of anal prolapse,bleeding,anus fall feeling,wet anus and pruritus ani.The relief rate of these symptoms in the two group were all high than 92%.There was one cases relapsed in the group 2 (the recurrence rate of 2%) was better than the group 1 (the recurrence rate of 13%) which were 8 case,there was a significant statistical significance (x2 =4.629,P ＜ 0.05) in the recurrence and clinical outcome.Conclusion Radical choose of PPH and selective MMH to treat Ⅲ ～ Ⅳ stage mixed hemorrhoids patients,which could relieve postoperative symptoms and acquire better long-term clinic outcomes.
ABSTRACT
Ojective To evaluate a new operation procedure for the treatment of circumferential mixed hemorrhoids. Methods 187 cases were treated by anal pad-preserving ligation resection, while 77 cases by routine procedures of stripping off the varicose masses of the external hemorrhoids and ligation the internal one as the control. Results Healing time of the operative wound were (17?4)d in the the study group and (24?4)d in the controls respectively( t =9.24, P 0.05). Postoperative urinary dysfunction: 14.4% of cases developed in the study group and 27.3% in the controls(? 2=8.42, P