Symptomatic pile tailored procedure. A new perspective for hemorrhoidal disease treatment.
Symptomatic pile tailored procedure. A new perspective for hemorrhoidal disease treatment.
复制标题
对症桩量身定制的程序。
DOI：
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复制
发表时间：
2017
影响因子：
0.8
通讯作者：
F. Feroci
中科院分区：
文献类型：
--
作者：
C. Elbetti;I. Giani;E. Novelli;J. Martellucci;F. Feroci
目的
本文的目的是评估定制的不同单桩治疗在痔疮临床结果中的作用。
学习材料
手术策略考虑仅根据每个病理性高利氏程度、是否存在纤维性、无弹性的多余内部绒毛（F）和是否存在外部病理性绒毛（外部绒毛充血或牙线颠覆（E）和患者不耐受的皮赘（S）），采用不同的程序来治疗病理性绒毛。我们采用二、三度痔疮固定术治疗，无F或ES；每第二度和第三度痔疮均进行痔疮固定术和外部组件切除术（E 或 S），以及完全半封闭痔切除术（所有第三度痔疮）以及 F 和 IV 度痔疮。术后自行服用镇痛药的天数是主要终点，短期/长期术后并发症、住院时间、再次入院和复发是次要终点。
结果
157 名患者接受治疗。痔疮固定术与完全切除或外部切除之间的出院时间没有差异。止痛药假设随着治疗痔疮的数量而增加（r = 0.227，p = 0.006）。我们观察到 10.2% 的早期并发症（48 小时）均继发于尿潴留，7% 的晚期并发症（2-15 天）仅在一次出血再次手术内发生。平均随访 16 个月后，没有患者需要进一步治疗痔疮。
讨论
事实证明，量身定制的方法对于短期和长期并发症以及复发而言是有效的。
结论
单桩量身定制处理效果良好。
关键词
切除、痔疮、痔切除术、痔疮固定术、疼痛、量身定制。
AIM
Aim of the present paper was to evaluate the role of tailored different single pile treatment in the clinical outcome of hemorrhoids.
MATERIAL OF STUDY
The surgical strategy considered to treat only pathological piles with different procedure according to each pathological Goligher's degree, presence of fibrous, inelastic redundant internal pile(F) and presence of external pathological pile (external pile congestion or subversion of dental line (E) and skin tag not tolerated from the patient (S)). We treated with Hemorrhoidopexy second and third degree pile without F or ES; with Hemorrhoidopexy and excision of external component every second and third degree pile with E or S and with complete semi-closed pile excision all third degree with F and IV degree piles. The number of post operative days of self administered analgesics was the primary end point and short/long term post operative complications, hospital stay, re-admission and recurrence were secondary end points.
RESULTS
157 patients were treated. No differences were noted in term of time of discharge between hemorrhoidopexy and complete or external excision. The painkiller assumption increases with the number of treated pile (r= 0.227, p=0.006). We observed 10.2% early complications (48h) all secondary to urinary retention and 7% late complications (2-15days) within only one reoperation for bleeding. After mean follow up of 16 months no patients required further treatments for hemorrhoids.
DISCUSSIONS
A tailored approach showed to be effective in terms of short and long term complications and moreover to relapse.
CONCLUSIONS
Single pile tailored treatment showed good results.
KEY WORDS
Excision, Hemorrhoids, Hemorrhoidectomy, Hemorrhoidopexy, Pain, Tailored.