Comparison of Procedure for Prolapse and Hemorrhoids with MilliganMorgan Hemorrhoidectomy for Acute Incarcerated Hemorrhoids_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SONG Chengfei ¹ , YU Hao ¹ , LI Chunyu ¹ , TANG Yuanxin ²

1.Department of Anorectal Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang 110032, China;;
2.Department of Gastrointestinal Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang 110032, China;

Corresponding author：

Keywords：

Anastomat; Procedure for prolapse and hemorrhoids; Milligan-Morgan hemorrhoidectomy; Incarcerated hemorrhoids; Treatment

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Objective To compare the curative effect of procedure for prolapse and hemorrhoids (PPH) with MilliganMorgan hemorrhoidectomy (MMH) for acute incarcerated hemorrhoids.
Methods A retrospective study of 103 patients with acute incarcerated hemorrhoids treated by surgery was performed. The patients were divided into PPH group (n=58) and MMH group (n=45) according to the different operation program who underwent. Operative time, pain score of VAS, time required for anodyne, postoperative complications, hospital stay, and hospital charges were compared.
Results The symptoms were both relieved in two groups patients. Although the hospital charges of patients in MMH group were fewer, the patients in PPH group had advantages of shorter operative time, less postoperative pain, lower requirement for anodyne, fewer complications (edema of anal edge), and shorter hospital stay (P lt;0.01).
Conclusion PPH is as safe and effective as MMH, and furthermore its short-term therapeutic effect is better than MMH.

Citation： SONG Chengfei ,YU Hao,LI Chunyu,TANG Yuanxin. Comparison of Procedure for Prolapse and Hemorrhoids with MilliganMorgan Hemorrhoidectomy for Acute Incarcerated Hemorrhoids. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(8): 808-811. doi: Copy

1.	宋维亮, 王振军. 痔的现代治疗评价 [J]. 中国普外基础与临床杂志, 2010; 17(2): 116118.
2.	Longo A. Treatment of hemorrhoids disease by reduction of mucosa and hemorrhoidal prolapse with a circular stapling device: a new procedure [C]. Rome, Italy. Proceedings of The 6th World Congress of Endoscopic Surgery, 1998: 36.
3.	姚礼庆, 钟芸诗. 吻合器痔上黏膜钉合术 [J]. 中华外科杂志, 2005; 43(23): 14971499.
4.	兰平, 彭慧. 重视结直肠肛门良性疾病诊治传承与发展 [J]. 中国普外基础与临床杂志, 2010; 17(2): 105108.
5.	李春雨, 聂敏, 张虹玺, 等. PPH治疗急性嵌顿痔（附56例报告） [J]. 大肠肛门病外科杂志, 2003; 9(4): 255256.
6.	李东冰, 谭竟范, 李华山, 等. 痔切除吻合器痔上黏膜环切术在脱垂性痔中的应用 [J]. 中国普外基础与临床杂志, 2007; 14(1): 9192.
7.	姚礼庆, 钟芸诗. 吻合器痔固定术的操作要求及术中并发症的预防和处理 [J]. 中国中西医结合外科杂志, 2005; 11(1): 1012.
8.	陈英. PPH与MilliganMorgan法治疗混合痔200例 [J]. 中国普外基础与临床杂志, 2008; 15(8): 613614.
9.	陈右江, 文明波, 姚红兵, 等. 千槐椒痔疮液结合常规方法治疗痔疮疗效观察 [J]. 人民军医, 2007; 50(3): 145146.
10.	中华医学会外科学分会结直肠肛门外科学组, 中华中医药学会肛肠病专业委员会, 中国中西医结合学会结直肠肛门病专业委员会. 痔临床诊治指南(2006版) [J]. 中华胃肠外科杂志, 2006; 9(5): 461463.
11.	鲁兵, 王赭, 陈勇, 等. 吻合器痔上黏膜环形切除术治疗老年人重度痔临床疗效观察 [J]. 中国普外基础与临床杂志, 2007; 14(5): 578579.
12.	韩炜，王振军，赵博，等. 痔组织弹性纤维退变和血管生成的机制及其意义 [J]. 中华胃肠外科杂志, 2005; 8(1): 5659.
13.	Laughlan K， Jayne DG， Jackson D， et al. Stapled haemorrhoidopexy compared to MilliganMorgan and Ferguson haemorrhoidectomy: a systematic review [J]. Int J Colorectal Dis, 2009; 24(3): 335344.
14.	Burch J, Epstein D, BabaAkbari A, et al. Stapled haemorrhoidectomy (haemorrhoidopexy) for the treatment of haemorrhoids: a systematic review and economic evaluation [J]. Health Technol Assess, 2008; 12(8): iiiiv, ixx, 1193.
15.	Uras C, Baca B, Boler DE. Circular stapled hemorrhoidopexy: experience of a single center with 445 cases [J]. World J Surg, 2008; 32(8): 17831788.
16.	Lomanto D, Katara AN. Stapled haemorrhoidopexy for prolapsed haemorrhoids: shortand longterm experience [J]. Asian J Surg, 2007; 30(1): 2933.
17.	兰平, 周旭毓, 吴小剑, 等. 吻合器痔上黏膜环形切除术与MilliganMorgan术的安全性和有效性随机对照研究的系统评价 [J]. 中华胃肠外科杂志, 2004; 7(4): 262266.
18.	鲁兵, 傅传刚, 王赭, 等. 吻合器痔上黏膜环形切除术治疗急性嵌顿性混合痔31例疗效分析 [J]. 临床外科杂志, 2006; 14(11): 752753.
19.	司徒光伟, 杜寒松. 吻合口位置高低与痔上黏膜环钉合术手术效果分析 [J]. 中华外科杂志, 2005; 43(23): 15061507.
20.	李春雨, 于好, 聂敏, 等. 吻合器痔固定术并发症的原因与处理 [J]. 中国医科大学学报, 2009; 38(5): 387388.
21.	Gravié JF, Lehur PA, Huten N, et al. Stapled hemorrhoidopexy versus milliganmorgan hemorrhoidectomy: a prospective, randomized, multicenter trial with 2year postoperative follow up [J]. Ann Surg, 2005; 242(1): 2935.
22.	杨晓东, 潘凯, 王东, 等. 吻合器痔上黏膜环形切除术与外剥内扎术的对比研究 [J]. 中华胃肠外科杂志, 2004; 7(5): 386388.

1. 宋维亮, 王振军. 痔的现代治疗评价 [J]. 中国普外基础与临床杂志, 2010; 17(2): 116118.
2. Longo A. Treatment of hemorrhoids disease by reduction of mucosa and hemorrhoidal prolapse with a circular stapling device: a new procedure [C]. Rome, Italy. Proceedings of The 6th World Congress of Endoscopic Surgery, 1998: 36.
3. 姚礼庆, 钟芸诗. 吻合器痔上黏膜钉合术 [J]. 中华外科杂志, 2005; 43(23): 14971499.
4. 兰平, 彭慧. 重视结直肠肛门良性疾病诊治传承与发展 [J]. 中国普外基础与临床杂志, 2010; 17(2): 105108.
5. 李春雨, 聂敏, 张虹玺, 等. PPH治疗急性嵌顿痔（附56例报告） [J]. 大肠肛门病外科杂志, 2003; 9(4): 255256.
6. 李东冰, 谭竟范, 李华山, 等. 痔切除吻合器痔上黏膜环切术在脱垂性痔中的应用 [J]. 中国普外基础与临床杂志, 2007; 14(1): 9192.
7. 姚礼庆, 钟芸诗. 吻合器痔固定术的操作要求及术中并发症的预防和处理 [J]. 中国中西医结合外科杂志, 2005; 11(1): 1012.
8. 陈英. PPH与MilliganMorgan法治疗混合痔200例 [J]. 中国普外基础与临床杂志, 2008; 15(8): 613614.
9. 陈右江, 文明波, 姚红兵, 等. 千槐椒痔疮液结合常规方法治疗痔疮疗效观察 [J]. 人民军医, 2007; 50(3): 145146.
10. 中华医学会外科学分会结直肠肛门外科学组, 中华中医药学会肛肠病专业委员会, 中国中西医结合学会结直肠肛门病专业委员会. 痔临床诊治指南(2006版) [J]. 中华胃肠外科杂志, 2006; 9(5): 461463.
11. 鲁兵, 王赭, 陈勇, 等. 吻合器痔上黏膜环形切除术治疗老年人重度痔临床疗效观察 [J]. 中国普外基础与临床杂志, 2007; 14(5): 578579.
12. 韩炜，王振军，赵博，等. 痔组织弹性纤维退变和血管生成的机制及其意义 [J]. 中华胃肠外科杂志, 2005; 8(1): 5659.
13. Laughlan K， Jayne DG， Jackson D， et al. Stapled haemorrhoidopexy compared to MilliganMorgan and Ferguson haemorrhoidectomy: a systematic review [J]. Int J Colorectal Dis, 2009; 24(3): 335344.
14. Burch J, Epstein D, BabaAkbari A, et al. Stapled haemorrhoidectomy (haemorrhoidopexy) for the treatment of haemorrhoids: a systematic review and economic evaluation [J]. Health Technol Assess, 2008; 12(8): iiiiv, ixx, 1193.
15. Uras C, Baca B, Boler DE. Circular stapled hemorrhoidopexy: experience of a single center with 445 cases [J]. World J Surg, 2008; 32(8): 17831788.
16. Lomanto D, Katara AN. Stapled haemorrhoidopexy for prolapsed haemorrhoids: shortand longterm experience [J]. Asian J Surg, 2007; 30(1): 2933.
17. 兰平, 周旭毓, 吴小剑, 等. 吻合器痔上黏膜环形切除术与MilliganMorgan术的安全性和有效性随机对照研究的系统评价 [J]. 中华胃肠外科杂志, 2004; 7(4): 262266.
18. 鲁兵, 傅传刚, 王赭, 等. 吻合器痔上黏膜环形切除术治疗急性嵌顿性混合痔31例疗效分析 [J]. 临床外科杂志, 2006; 14(11): 752753.
19. 司徒光伟, 杜寒松. 吻合口位置高低与痔上黏膜环钉合术手术效果分析 [J]. 中华外科杂志, 2005; 43(23): 15061507.
20. 李春雨, 于好, 聂敏, 等. 吻合器痔固定术并发症的原因与处理 [J]. 中国医科大学学报, 2009; 38(5): 387388.
21. Gravié JF, Lehur PA, Huten N, et al. Stapled hemorrhoidopexy versus milliganmorgan hemorrhoidectomy: a prospective, randomized, multicenter trial with 2year postoperative follow up [J]. Ann Surg, 2005; 242(1): 2935.
22. 杨晓东, 潘凯, 王东, 等. 吻合器痔上黏膜环形切除术与外剥内扎术的对比研究 [J]. 中华胃肠外科杂志, 2004; 7(5): 386388.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Comparison of Procedure for Prolapse and Hemorrhoids with MilliganMorgan Hemorrhoidectomy for Acute Incarcerated Hemorrhoids

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