Clinical Research Of The External Excision And Internal Ligation With Anal Canal Reconstruction In The Treatment Of Incarcerated Hemorrhoids

Objectives This study aims to observe the clinical efficacy of external excision and internal ligation with anal canal reconstruction in the treatment of incarcerated hemorrhoids in order to provide a new idea and method for the clinical treatment of incarcerated hemorrhoids.Methods A total of 84 patients with incarcerated hemorrhoids who were hospitalized in the Anorectal Department of Baoding No.1 Hospital of Traditional Chinese Medicine from September 2018 to November 2019 were enrolled in the study.The patients were randomly divided into the treatment group(n=42)and control group(n=42)using a random number table.The patients in the treatment group were treated with external excision and internal ligation with anal canal reconstruction while the patients in the control group received the Milligan Morgan hemorrhoidectomy.The postoperative scores of primary symptoms(prolapse and perianal pain)and the postoperative condition of secondary symptoms(anal marginal edema,bleeding,anal stenosis,anal flatness and incision healing time)were observed and recorded.The clinical efficacy was evaluated.The patients were followed up 3 months after operation in order to observe the recurrence of the disease.Results 1 One patient in the treatment group fell off;one patient in the control group fell off and one patient was excluded.Finally,a total of 41 patients in the treatment group and 40 patients in the control group completed the study.2 Before treatment,there were no significant differences in gender,age,incarcerated time,pathological changes after incarceration,prolapse and perianal pain after statistical analysis.3 Comparison of primary symptoms after operation: 1)Prolapse: At day 14 after operation,the difference was not statistically significant between the two groups(P>0.05).2)Perianal pain score: The difference at day 1,3,7 and 14 after operation was statistically significant between the two groups(P<0.05).The difference at same time point was statistically significant between the two groups(P<0.05).4 Comparison of secondary symptoms after operation: 1)Perianal edema score: The difference at day 3,7 and 14 after operation was statistically significant between the two groups(P<0.05).The difference at same time point was statistically significant between the two groups(P<0.05).2)Bleeding score: The difference at day 3,5 and 7 after operation was statistically significant between the two groups(P<0.05).The difference at same time point was statistically significant between the two groups(P<0.05).3)Anal stenosis: The difference at day 14 after operation was not statistically significant between the two groups(P>0.05).4)Anal flatness: The difference at month 3 after operation was statistically significant between the two groups(P<0.05).5)Incision healing time: The difference was statistically significant between the two groups(P<0.05).5 Evaluation of clinical efficacy: 1)Comparison of primary symptom scores at day 14 before and after operation: The difference was statistically significant between the two groups(P<0.05).The difference in preoperative scores was not statistically significant between the two groups(P>0.05).The difference in postoperative scores at day 14 was statistically significant between the two groups(P<0.05).2)Comparison of clinical efficacy: The difference in clinical efficacy was statistically significant between the two groups(P<0.05).6 Comparison of postoperative recurrence: The difference was not statistically significant between the two groups(P>0.05).Conclusions External excision and internal ligation with anal canal reconstruction can effectively relieve the prolapse and pain symptoms of incarcerated hemorrhoids,ease the postoperative perianal pain,anal margin edema and bleeding,and promote the incision healing,as well as ensure the normal function and smooth appearance of the anus.The efficacy of external excision and internal ligation with anal canal reconstructionis is definite in the treatment of incarcerated hemorrhoids.It is worth popularizing and applying clinically.Figure0;Table16;Reference 133...