Comparative Study of Hemorrhoidectomy and Rubber Band Ligation in Treatment of Second and Third Degree Hemorrhoids in Kashmir
Comparative Study of Hemorrhoidectomy and Rubber Band Ligation in Treatment of Second and Third Degree Hemorrhoids in Kashmir
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DOI：
10.1007/s12262-012-0498-4
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发表时间：
2013-10-01
影响因子：
0.4
通讯作者：
Sharief, Banday M.
中科院分区：
文献类型：
--
作者：
Gagloo, Mushtaq A.;Hijaz, S. Wardul;Sharief, Banday M.
内痔的诊断主要依靠直肠镜检查。这项研究评估了橡皮筋结扎术(RBL)和内痔切除术的比较结果。本研究于2003年1月至2004年6月期间进行，为期一年半。它包括100名患有二度或三度主痔的患者，他们在克什米尔斯利那加SMHS医院的外科门诊就诊。随机选择100例患者，随机分为两组，每组50例(切除术组和RBL组)。每个患者都接受乙状结肠镜检查，以排除直肠乙状结肠上方的其他病变。排除裂隙、瘘管和恶性肿瘤患者。所有参数均被记录下来，并进行分析。本研究采用SPSS统计软件进行统计分析，采用描述性统计和相关分析进行最终评价。内痔切除术和直肠癌根治术同样有效，尤其是对二度内痔。然而，由于RBL是一种门诊手术，对患者来说具有成本效益，为更多的患者节省了大量的医院床位，并减轻了手术等待名单的压力，因此应该被认为是二度痔的一线治疗方法。尽管RBL在治疗三度痔方面不如内痔切除术有效，但它确实改善了出血和脱垂，强烈推荐给不适合手术或合并有禁忌麻醉的疾病的患者。应将RBL作为治疗二度内痔的一线治疗方法。然而，对于Ⅲ度内痔，手术效果较好，对于有手术或麻醉禁忌症的患者，建议将RBL作为一线治疗。
The diagnosis of hemorrhoids is primarily based on the proctoscopic examination. The study evaluates comparative results of rubber band ligation (RBL) and hemorrhoidectomy. This study was conducted over a period of 1 1/2 year from Jan 2003 to June 2004. It includes 100 patients having second- or third-degree primary hemorrhoids who attended surgical OPD of SMHS Hospital Srinagar, Kashmir. These 100 patients were selected randomly and divided into two groups of 50 patients each (hemorrhoidectomy group and RBL group). Each patient was subjected to sigmoidoscopy to exclude other lesion higher up in rectosigmoid. Patients of fissure, fistulae, and malignancy were excluded. All parameters were recorded and finally analysed. The statistical analysis of the study was done using SPSS statistical package in which we used descriptive statistics and correlation analysis for the final evaluation. Hemorrhoidectomy and RBL are equally effective especially in second- degree hemorrhoids. However, RBL should be considered the first-line treatment in second- degree hemorrhoids because being an outpatient procedure, it is cost effective for the patients, saves many a hospital beds for more sick patients, and takes the pressure off the surgical waiting list. Although RBL is not as effective as hemorrhoidectomy in third-degree hemorrhoid, it does improve bleeding and prolapse and is highly recommended for patients who are unfit for surgery or have concurrent disease that contraindicates anesthesia. RBL should be considered as the first-line treatment for second- degree hemorrhoid. However, in the third-degree hemorrhoids, hemorrhoidectomy achieves better results, and RBL is recommend as the first-line treatment for those patients in whom there is contraindication for surgery or anesthesia.