Surgical Effect of Tissue Selecting Therapy Stapler in Treatment of Hemorrhoid_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SUNHao-bo ,  MENGQing-hui , LILong , PEITie-min

Department of Anorectal Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China;

Corresponding author：

MENGQing-hui, Email: hui-90@163.com

Keywords：

Hemorrhoid; Tissue selecting therapy stapler; Procedure for prolapse and hemorrhoids; Effect

DOI：

10.7507/1007-9424.20160192

Video：

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Objective To compare the clinical effect of tissue selecting therapy stapler (TST) and procedure for prolapse and hemorrhoids (PPH) in treatment of hemorrhoid in Ⅲ-Ⅳ degree. Methods Clinical data of 80 cases of hemorrhoid in Ⅲ-Ⅳ degree who treated in The First Affiliated Hospital of Harbin Medical University from May 2015 to July 2015 were retrospectively collected. All the 80 cases were divided into TST group (n=40) and PPH group (n=40) according to the surgical types. The comparison of the clinical effect of 2 groups was performed. Results The operative time, hospital stay, intraoperative blood loss, anal fall bilge feeling score, postoperative pain score at 3 time points, and the incidence of anal secretions of TST group were lower or shorter than those corresponding indexes of PPH group (P<0.05). But there was no significant difference in cure rate, the incidence of urinary retention, the incidence of anal stenosis, the incidence of intractable pain, and satisfaction situation between the 2 groups (P>0.05). All of the cases were followed up for 3 months, during the follow-up period, no one suffered from rectal vaginal fistula, fecal incontinence, and recurrence. Conclusion TST and PPH both have satisfactory effect in treatment of hemorrhoid in Ⅲ-Ⅳ degree, but TST has advan- tages of less blood loss, shorter operative time, rapid postoperative recovery, and less pain.

Citation： SUNHao-bo, MENGQing-hui, LILong, PEITie-min. Surgical Effect of Tissue Selecting Therapy Stapler in Treatment of Hemorrhoid. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(6): 727-731. doi: 10.7507/1007-9424.20160192 Copy

1.	Thomson WH. The nature of hemorrhoids. Br J Surg, 1975, 62(7):542-552.
2.
3.	Naldini G, Martellucci J, Rea R, et al. Tailored prolapse surgery forthe treatment of haemorrhoids and obstructed defecation syndromewith a new dedicated device: TST STARR Plus. Int J Colorectal Dis,2014, 29(5): 623-629.
4.	Khubchandani IT. Partial stapled hemorrhoidopexy versus circularstapled hemorrhoidopexy for grade Ⅲ-Ⅳ prolapsing hemorrhoids:a two-year prospective controlled study. Tech Coloproctol, 2012,16(5): 345, 347-348.
5.	Lin HC, He QL, Ren DL, et al. Partial stapled hemorrhoidopexy: aminimally invasive technique for hemorrhoids. Surg Today, 2012,42(9): 868-875.
6.	万仁辉, 温宜清, 邓浩财. 选择性痔上黏膜切除吻合术治疗重度内痔的临床研究. 岭南现代临床外科, 2013, 13(3): 184-188.
7.	Raahave D, Jepsen LV, Pedersen IK. Primary and repeated stapledhemorrhoidopexy for prolapsing hemorrhoids: follow-up to fiveyears. Dis Colon Rectum, 2008, 51(3): 334-341.
8.	宋维亮, 王振军. 痔的现代治疗评价. 中国普外基础与临床杂志,2010, 17(2): 116-118.
9.	Ommer A, Hinrichs J, Möllenberg H, et al. Long-term results afterstapled hemorrhoidopexy: a prospective study with a 6-year followup.Dis Colon Rectum, 2011, 54(5): 601-608.
10.	Tjandra JJ, Chan MK. Systematic review on the procedure forprolapse and hemorrhoids (stapled hemorrhoidopexy). Dis ColonRectum, 2007, 50(6): 878-892.
11.	Hetzer FH, Demartines N, Handschin AE, et al. Stapled vs excisionhemorrhoidectomy: long-term results of a prospective randomizedtrial. Arch Surg, 2002, 137(3): 337-340.
12.	Nisar PJ, Acheson AG, Neal KR, et al. Stapled hemorrhoidopexycompared with conventional hemorrhoidectomy: systematic reviewof randomized, controlled trials. Dis Colon Rectum, 2004, 47(11):1837-1845.
13.	范雷涛, 谷建南, 李玉博, 等. 吻合器痔上黏膜环形切除术辅助剪口结扎治疗357 例混合痔患者的长期疗效评价. 中国普外基础与临床杂志, 2015, 22(5): 623-625.
14.	王子恒, 孟庆辉. 吻合器痔上黏膜钉合术应用的相关问题. 中国普外基础与临床杂志, 2010, 17(11): 1213-1215.
15.	高显华, 傅传刚, Nabieu PF-W. PPH 术后复发与皮赘残留: 应注意区分两者. 中国实用外科杂志, 2009, 29(12): 1012-1017, 1024.
16.	林宏城, 任东林, 谢尚奎, 等. 选择性痔上黏膜切除钉合术与痔上黏膜环切钉合术的对比研究. 广东医学, 2011, 32(11): 1457-1460.
17.	Naldini G, Fabiani B, Menconi C, et al. Tailored prolapse surgeryfor the treatment of hemorrhoids with a new dedicated device: TSTStarr plus. Int J Colorectal Dis, 2015, 30(12): 1723-1728.
18.	Garcea G, Sutton CD, Lloyd TD, et al. Management of benign rectalstrictures: a review of present therapeutic procedures. Dis ColonRectum, 2003, 46(11): 1451-1460.
19.	Brisinda G, Vanella S, Cadeddu F, et al. Surgical treatment of analstenosis. World J Gastroenterol, 2009, 15(16): 1921-1928.
20.	宣恩胜, 江洪亮. 选择性痔上黏膜切除钉合术(TST) 治疗痔病的临床研究. 中国医药指南, 2014, 12(19): 78-80.
21.	Martellucci J, Naldini G, Del Popolo G, et al. Sacral nerve modulationin the treatment of chronic pain after pelvic surgery. ColorectalDis, 2012, 14(4): 502-507.
22.	杨向东, 贾英田, 赵希忠, 等. TST 术后常见并发症的原因及对策( 附100 例临床报告）. 结直肠肛门外科, 2011, 17(2): 101-103.
23.	Lin HC, Lian L, Xie SK, et al. The tissue-selecting technique: segmentalstapled hemorrhoidopexy. Dis Colon Rectum, 2013, 56(11):1320-1324.

1. Thomson WH. The nature of hemorrhoids. Br J Surg, 1975, 62(7):542-552.
2.
3. Naldini G, Martellucci J, Rea R, et al. Tailored prolapse surgery forthe treatment of haemorrhoids and obstructed defecation syndromewith a new dedicated device: TST STARR Plus. Int J Colorectal Dis,2014, 29(5): 623-629.
4. Khubchandani IT. Partial stapled hemorrhoidopexy versus circularstapled hemorrhoidopexy for grade Ⅲ-Ⅳ prolapsing hemorrhoids:a two-year prospective controlled study. Tech Coloproctol, 2012,16(5): 345, 347-348.
5. Lin HC, He QL, Ren DL, et al. Partial stapled hemorrhoidopexy: aminimally invasive technique for hemorrhoids. Surg Today, 2012,42(9): 868-875.
6. 万仁辉, 温宜清, 邓浩财. 选择性痔上黏膜切除吻合术治疗重度内痔的临床研究. 岭南现代临床外科, 2013, 13(3): 184-188.
7. Raahave D, Jepsen LV, Pedersen IK. Primary and repeated stapledhemorrhoidopexy for prolapsing hemorrhoids: follow-up to fiveyears. Dis Colon Rectum, 2008, 51(3): 334-341.
8. 宋维亮, 王振军. 痔的现代治疗评价. 中国普外基础与临床杂志,2010, 17(2): 116-118.
9. Ommer A, Hinrichs J, Möllenberg H, et al. Long-term results afterstapled hemorrhoidopexy: a prospective study with a 6-year followup.Dis Colon Rectum, 2011, 54(5): 601-608.
10. Tjandra JJ, Chan MK. Systematic review on the procedure forprolapse and hemorrhoids (stapled hemorrhoidopexy). Dis ColonRectum, 2007, 50(6): 878-892.
11. Hetzer FH, Demartines N, Handschin AE, et al. Stapled vs excisionhemorrhoidectomy: long-term results of a prospective randomizedtrial. Arch Surg, 2002, 137(3): 337-340.
12. Nisar PJ, Acheson AG, Neal KR, et al. Stapled hemorrhoidopexycompared with conventional hemorrhoidectomy: systematic reviewof randomized, controlled trials. Dis Colon Rectum, 2004, 47(11):1837-1845.
13. 范雷涛, 谷建南, 李玉博, 等. 吻合器痔上黏膜环形切除术辅助剪口结扎治疗357 例混合痔患者的长期疗效评价. 中国普外基础与临床杂志, 2015, 22(5): 623-625.
14. 王子恒, 孟庆辉. 吻合器痔上黏膜钉合术应用的相关问题. 中国普外基础与临床杂志, 2010, 17(11): 1213-1215.
15. 高显华, 傅传刚, Nabieu PF-W. PPH 术后复发与皮赘残留: 应注意区分两者. 中国实用外科杂志, 2009, 29(12): 1012-1017, 1024.
16. 林宏城, 任东林, 谢尚奎, 等. 选择性痔上黏膜切除钉合术与痔上黏膜环切钉合术的对比研究. 广东医学, 2011, 32(11): 1457-1460.
17. Naldini G, Fabiani B, Menconi C, et al. Tailored prolapse surgeryfor the treatment of hemorrhoids with a new dedicated device: TSTStarr plus. Int J Colorectal Dis, 2015, 30(12): 1723-1728.
18. Garcea G, Sutton CD, Lloyd TD, et al. Management of benign rectalstrictures: a review of present therapeutic procedures. Dis ColonRectum, 2003, 46(11): 1451-1460.
19. Brisinda G, Vanella S, Cadeddu F, et al. Surgical treatment of analstenosis. World J Gastroenterol, 2009, 15(16): 1921-1928.
20. 宣恩胜, 江洪亮. 选择性痔上黏膜切除钉合术(TST) 治疗痔病的临床研究. 中国医药指南, 2014, 12(19): 78-80.
21. Martellucci J, Naldini G, Del Popolo G, et al. Sacral nerve modulationin the treatment of chronic pain after pelvic surgery. ColorectalDis, 2012, 14(4): 502-507.
22. 杨向东, 贾英田, 赵希忠, 等. TST 术后常见并发症的原因及对策( 附100 例临床报告）. 结直肠肛门外科, 2011, 17(2): 101-103.
23. Lin HC, Lian L, Xie SK, et al. The tissue-selecting technique: segmentalstapled hemorrhoidopexy. Dis Colon Rectum, 2013, 56(11):1320-1324.

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Surgical Effect of Tissue Selecting Therapy Stapler in Treatment of Hemorrhoid

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