| PrefaceHemorrhoid is a clumping which has been become as the pathological hy-pertrophia and move down of the anus pad and stasis of blood stream of vascular plexus under the skin crissum . If it accompany symptoms such as blooding and prolapse etc, we call it is hemorrhoid . Hemorrhoid is one of the most frequent diseases,it' s prevalence rate reach up to 48 percent. Since 1970, Human has new recognition to the essence an treatment of the hemorrhoid, change the thought of the past , which think the mechanism of the hemorrhoid is phlebeurys-ma under the mucous membrane of anal canal. The study about the reason of the hemorrhoid has became very active recently. This cause the great change of the treatment concept of the hemorrhoid. There have many methods of the treatment to the hemorrhoid, such as drug treatment, loop ligature treatment and injection of sclerosing agent etc. These methods are applied mainly in I — II degree hemorrhoid. The treatment of Ⅲ - Ⅳ degree hemorrhoid are mainly operation. The traditional operation method is Milligan - Morgan, though this method is a way of safe and effective, it have many faults such as severe postoperative pain, long of the time stay in the hospital and may led to the complication like anal stenosis. In 1988, Longo raise appling precedure for prolapse and hemorrhoids (PPH)to the field of hemorrhoid treatment. Many expert study it soon after. They think this method appears to be safe, effective and rapid, causing few postoperative complications and minimal postoperative pain. But long - term outcome needs a further observation. We will compare the differences between PPH and Milligan - Morgan in terms of hemorrhoid , and evaluate the value of thePPH in the clinical application.ObjectiveThe traditional operation method to treat hemorrhoid is Milligan - Morgan. This method is a way of safe and effective, it have many faults such as severe postoperative pain,long of the time stay in the hospital and may led to the complication like anal stenosis. Procedure for prolapse and hemorrhoids (PPH ) appears to be safe, effective and rapid, causing few postoperative complications and minimal postoperative pain. Our study will compare the differences between PPH and Milligan - Morgan in terms of hemorrhoid, and evaluate the value of the PPH in the clinical application.MethodsSixty cases of this study comes from our hospital from March 2003 to March 2005, which have HI - IV degree hemorrhoids admitted for surgical treatment were randomly assigned to PPH ( n = 30) or Milligan - Morgan ( n = 30) , then compare to the differences between the two groups in terms of operating time, postoperative pain time, time required for returning to normal activity, length of hospital stay, postoperative complications, time of wound healing and hospital fee.ResultsTwo group patients have completed the operation successfully. After the patient in the group of the stapler completed anastomosis, we examined the distance that between stoma and anocutaneous line is( 1.92 ±0.20) cm. There are six cases have impulsivity blooding (20%), they need to transfix haemostasis. There have three cases have hypertrophy of the anal papilla (10%), and there have four cases have cutaneous tag obviously out of the edge of the anus (13.3% ) ,they have to treat by the way of injecting hemorrhoid injection . Thedifference was statistically significant between the two groups in terms of operating time, postoperative pain time, time required for returning to normal activity, length of hospital stay, incidence rate of postoperative complications, postoperative blood time of wound healing and hospital fee. The above factors were found more favorable in PPH group. The symptom improvement rate was 93% in PPH group and 83% in Milligan group.ConclusionTreatment of hemorrhoids with a circular stapler appears to be safe, effective, causing few postoperative complications, fast wound healing, more satisfaction of patients, having value of application and popularize in clinical treatment. |
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