ABSTRACT
Objective To analyze the complications after procedure for prolapse and hemorrhoids (PPH) in treating severe mucocutaneous hemorrhoids.Methods The clinical data of 550 patients with severe mucocutaneous hemorrhoids who were admitted to the Hangzhou Hospital of Nanjing Medical University from January 2005 to December 2013 were retrospectively analyzed.All the patients were treated by PPH or PPH + external hemorrhoids resection.The postoperative complications were recorded and assessed.Patients were followed up via outpatient examination and telephone interview till June 2014.Results Operation was successfully carried out on all the 550 patients.The operation time and duration of hospital stay were (15 ± 10)minutes and (4.2 ± 1.8)days,respectively.A total of 445 patients were followed up for 6-60 months,with the median time of 28 months.The overall incidence of complications was 14.61％ (65/445).Forty-five patients were complicated with anal pain,12 with hemorrhoid recurrence,7 with bleeding,5 with dysporia,4 with anastomotic stenosis and 2 with rectal and perianal infection.Of the 12 patients with hemorrhoids recurrence,5 was alleviated by medication and 7 received PPH for the second time.Of the 4 patients with anastomotic stricture,the condition of 2 patients were alleviated by anus dilatation,and the condition of 1 patient was alleviated by balloon dilatation under enteroscope,1 patient received circular incision of the stricture because of severe stricture and failed of conservative treatment.Of the 2 patients with rectal and perianal infection,1 was alleviated by intravenous and local medication,and the other patient who was complicated with anal fistula was alleviated by surgery.The condition of other patients was improved after symptomatic treatment.Conclusions PPH is effective and safe for the treatment of severe mucocutaneous hemorrhoids.The main complication is anal pain,and it could be cured or alleviated by symptomatic treatment.
ABSTRACT
Objective To investigate the consistent long-term clinical efficacy of the procedure for prolapsed hemorrhoids (PPH) treatment for hemorrhoids.Methods Data of 87 patients with third-and fourth-degree hemorrhoids treated by surgical procedure for prolapsed hemorrhoids were collected.In all cases,third-degree hemorrhoids in 65 cases,fourth-degree hemorrhoids in 22 cases,median followed up after PPH was (3.8 ± 0.5) years.The long-term efficacy and the occurrence of complications were followed up to assess the effect of surgical procedure for prolapsed hemorrhoids.Results In patients with third-degree hemorrhoids,bleeding recurred in 2 cases (3.1％) for again bleeding,for anal bulge in 4 cases (6.2％).In patients with fourth-degree hemorrhoids,prolapse recurred in 2 cases (9.1％) for bleeding in 5 cases (22.7％).anal bulge 3 patients (13.6％),defecation difficult in one case (4.5％),one-degree of fecal incontinence in 1 case (4.5％),no other complications found,such as anal pain,anal stenosis,foreign body discomfort and fecal urgency.The chi-square test for comparison analysis suggested that:third-degree hemorrhoids postoperative prolapse and bleeding recurrence rate was significantly lower than fourth-degree hemorrhoids.Conclusions Procedure for prolapsed hemorrhoids treatment for hemorrhoids is safe and feasible,has small trauma,little pain,and definite efficacy,fewer complications,shorter hospital stay,lower reoperation rate,etc.But the long-term efficacy for third-degree hemorrhoids is superior to the fourth-degree hemorrhoids.