Comparison Of Efficacy Between Procedure For Prolapse And Hemorrhoids And Improved Circular Hemorrhoidectomy For Circular Mixed Hemorrhoids

Objective: The aim of the study is to compare the clinical efficacy between Procedure for Prolapse and Hemorrhoids(PPH)and improved circular hemorrhoidectomy( ICH) for circular mixed hemorrhoids and explore the safe and effective operation method for circular mixed hemorrhoids.Methods: 80 inpatients with circular mixed hemorrhoids(â…¢~â…£) in the Department of Gastrointestinal Surgery of our hospital from September 2013 to September 2014 were selected accoding to the including and excluding criteria and divided into two groups by the different operation methods. 40 patients in group A were operated by PPH and 40 patients in group B by ICH.All of the operations were performed by the same surgeons. The immediate and long-term clinical efficacy was compared after the operation between the two groups, including: operating time,intraoperative blood loss, postoperative hospital stay,time to return to work,postoperative outcome,patient satisfaction,postoperative complications(postoperative pain, postoperative bleeding, anus bulge, anorectal stricture, retention of urine and fecal incontinence etc), hospitalization costs and recurrence rate etc.All of the data obtained were analysed by the SPSS17.0 statistical software.Results: Preoperative clinical data between the two groups showed no statistic significance(P>0.05).Group A had a reduction in operating time and intraoperative blood loss compared with group B,and the difference had statistic significance(P<0.05). The length of the postoperative hospital stay and time to return to work in group A were lower than group B,reaching statistic significance(P<0.05). Group A was associated with lower pain score after operation,less anus bulge,less retention of urine and less fecal incontinence compared with group B(P<0.05).The hospitalization costs were higher in group A than that in group B,and the difference achieved statistical significance(P<0.05).There were no statistically significant differences in postoperative bleeding,anorectal stricture,postoperative outcome and patient satisfaction(P>0.05).After 12 months of follow-up, group A had four cases of recurrence(10%),while one in group B(2.5%) but the difference between the two groups was not statistically significant(P=0.356).Conclusion: PPH and ICH are both safe and effective surgical methods for circular mixed hemorrhoids. Compared with ICH,PPH is associated with some short-term advantages such as shorter operating time,less intraoperative blood loss,shorter hospital stay,faster recovery,less pain, less retention of urine and a better control ability of stool,etc. But the cost of PPH is higher and the long-term effect is unclear,with the recurrence rate being likely to increase.The type of operation method should choose according to the specific clinical situation in the treatment of circular mixed hemorrhoids.