中国现代手术学杂志2016，Vol.20Issue(2)：90-92,3.DOI:10.16260/j.cnki.1009-2188.2016.02.004
吻合器痔上黏膜环切术荷包缝合的体会
Experience in the Operation Details to Reduce the Complications of PPH
孙颢 1陈佳栋 1高友福1
作者信息
- 1. 上海市静安区中心医院复旦大学附属华山医院静安分院普外科,上海200040
- 折叠
摘要
Abstract
Objective To assess the experience in the operation details to reduce the complications of procedure for prolapsed and hemorrhoids (PPH).Methods The clinical data of 356 hemorrhoid cases performed PPH in our hospital from October 2007 to August 2015 were analyzed retrospectively,including 56 of stage Ⅱ and 300 of stage Ⅲ/Ⅳ or mixed hemorrhoids.During the PPH,the height and depth of pouch suture were chosen by individual conditions and postoperative complications as anastomotic stoma bleeding were observed.Results In the 56 cases with Ⅱ period of hemorrhoids:The distance from pouch line to dentate line was 2.5 to 4 cm in 16 cases,with the postoperative pain rate of 25％ (4/16);Pouch apart to dentate line was 4 to 6 cm in 40 patients,there were no postoperative pain.Poor suspension was not found during the one month follow-up after the surgery.In the 300 cases with Ⅲ/Ⅳ period hemorrhoids or mixed hemorrhoids:The distance from pouch line to the dentate line was 2.5 to 4 cm in 238 cases,with postoperative pain rate of 7.6％(18/238) and postoperative poor suspension rate of 2.5％ (6/238);Pouch apart from the dentate line was 4to 6 cm in 62 cases,with postoperative poor suspension rate of 35.5％ (22/238).Among 356 cases,there were 30 cases (8.4％) took place active anastomotic bleeding,including 20 cases with incomplete resection of mucosa ring and improved by "8" suture cross anastomosis.4 cases (1.1％) of postoperative anastomotic stenosis were found muscle fibers in the removal mucosa ring.Conclusions The pouch height from the dentate line was chosen 4 to 6 cm for the stage Ⅱ hemorrhoid patients with the major symptom of bleeding to decrease the post-operative pain,and was 2.5 to 4 cm for stage Ⅲ/Ⅳ or mixed hemorrhoid cases to improved the suspension result.The depth of pouch suture should be to the submucosa,it can reduce the incidence of anastomotic stenosis and bleeding.关键词
痔上黏膜环切术/并发症Key words
PPH/complications分类
医药卫生引用本文复制引用
孙颢,陈佳栋,高友福..吻合器痔上黏膜环切术荷包缝合的体会[J].中国现代手术学杂志,2016,20(2):90-92,3.
