Doppler-guided hemorrhoidal dearterialization with laser (HeLP): a prospective analysis of data from a multicenter trial
Doppler-guided hemorrhoidal dearterialization with laser (HeLP): a prospective analysis of data from a multicenter trial
复制标题
DOI：
10.1007/s10151-018-1839-5
复制
发表时间：
2018-08-01
影响因子：
3.3
通讯作者：
Tamburini, A. M.
中科院分区：
文献类型：
--
作者：
Giamundo, P.;Braini, A.;Tamburini, A. M.
背景：多普勒引导下的激光内切手术(HELP)是治疗症状性内痔的一种新的微创技术。这项多中心研究的目的是前瞻性地评估HeLP治疗患者的临床结果和患者满意度。方法帮助指征包括内科治疗无效、轻度脱垂的症状性内痔患者。评估临床疗效，评估症状缓解和患者满意度。出血次数和急性内痔相关症状的频率分别为0至4分(4分=每周3次以上)和0分至3分(3分=每年5次以上)。采用视觉模拟评分(VAS)对患者的生活质量、休息时疼痛和排空时疼痛进行评分，并记录术中和术后并发症。结果入选患者2 84例(男183例，女101例)，平均年龄47.5岁。随访6个月，症状完全缓解257/284例(90.5%)，满意275/284例(96.8%)。对144名患者至少随访12个月的分析显示，130/144(90.3%)的症状得到缓解，139/144(96.5%)的患者满意。出血评分从2.4±1.07提高到0.36+/-0.49，差异有统计学意义(P<0.05)。
BackgroundDoppler-guided hemorrhoidal laser procedure (HeLP) is a new minimally invasive technique to treat symptomatic hemorrhoids. The aim of this multicenter study was to prospectively assess clinical results and patients' satisfaction in patients treated with HeLP.MethodsIndications for HeLP included patients with symptomatic hemorrhoids resistant to medical therapy, with low-grade prolapse. Clinical efficacy was evaluated assessing resolution of symptoms and patient satisfaction. Frequency of bleeding and frequency of acute hemorrhoid-related symptoms were given a score of 0 to 4 (where 4=more than 3 episodes/week) and 0 to 3 (where 3=more than 5 episodes/year), respectively. Quality of life, pain at rest, and pain with evacuation were scored using a visual analogue scale (VAS) of 0 to 10. Intra- and postoperative complications were recorded. Potential predictive factors for failure were assessed.ResultsTwo hundred and eighty-four patients (183 males, 101 females) with a mean age of 47.5years were included in the study. At 6-month follow-up, symptoms had completely resolved in 257/284 (90.5%) and 275/284 (96.8%) patients were satisfied with the results. An analysis of a subgroup of 144 patients followed up for a minimum of 12months revealed a resolution of symptoms in 130/144 (90.3%) and satisfaction in 139/144 (96.5%). There was a statistically significant improvement of the bleeding score (from 2.4 1.07 to 0.36 +/- 0.49; p