Surgical treatment of piles -: Prospective, randomized study of packs vs. Milligan-Morgan hemorrhoidectomy
Surgical treatment of piles -: Prospective, randomized study of packs vs. Milligan-Morgan hemorrhoidectomy
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DOI：
10.1007/bf02238242
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发表时间：
1998-02-01
影响因子：
3.9
通讯作者：
Izbicki, JR
中科院分区：
文献类型：
--
作者：
Hosch, SB;Knoefel, WT;Izbicki, JR
目得：目前的前瞻性随机临床试验比较了根据Parks和Milligan-Morgan的手术痔切除术在住院时间、丧失工作能力的持续时间、症状缓解、发病时间和患者便利性方面的结果。方法：将34例Ⅲ度、Ⅳ度内痔患者随机分为两组。手术前，所有患者都接受了标准问卷调查，然后进行直肠检查。所有患者在术后1、2、4、8、12周进行随访和检查。结果：术后未出现严重并发症。住院时间（Parks痔切除术为3.2天，Milligan-Morgan痔切除术为4.6天; 95%置信区间分别为0.2和2.6; P = 0.02）和平均丧失工作能力时间（Parks痔切除术为12.3天，Milligan-Morgan痔切除术为20.2天; 95%置信区间分别为5.7和10.2; P < 0.001）在Milligan-Morgan和Parks患者之间存在显著差异。直到手术后两周，Milligan-Morgan痔切除术患者经历了明显更多的疼痛。结论：我们的研究证实，这两种手术都是安全的，易于执行，并导致令人满意的结果。然而，Parks手术是首选，因为它最大限度地减少了患者的术后不适，更经济，住院时间明显减少，并且恢复工作的时间更短。
PURPOSE: The present prospective, randomized clinical trial compares the outcome of surgical hemorrhoidectomy according to Parks and Milligan-Morgan in terms of hospital stay, duration of incapacity to work, symptom relief, length of morbidity, and patient convenience. METHODS: Thirty-four consecutive patients with third Or fourth degree internal hemorrhoids were randomly allocated to the two groups. Before surgery, all patients were interviewed using a standard questionnaire, followed by rectal examination. Ail patients underwent a follow-up interview and examinations 1, 2, 4, 8, and 12 weeks after the operation. RESULTS: No serious postoperative complications were seen. Length of hospital stay (3.2 days for Parks hemorrhoidectomy vs. 4.6 days for Milligan-Morgan hemorrhoidectomy; 95 percent confidence interval, 0.2 and 2.6, respectively; P = 0.02) and mean duration of incapacity to work (12.3 days for Parks hemorrhoidectomy vs. 20.2 days for Milligan-Morgan hemorrhoidectomy; 95 percent confidence interval, 5.7 and 10.2, respectively; P < 0.001) differed significantly between the Milligan-Morgan and Parks patients. Until two weeks after the operation, Milligan-Morgan hemorrhoidectomy patients experienced significantly more pain. CONCLUSIONS: Our study confirms that both operations are safe, easy to perform, and lead to satisfactory results. However, the Parks procedure is the preferred option, because it minimizes patients' postoperative discomfort, is more economic, has a significantly reduced hospital stay, and has a shorter time for return to work.