Tissue-selecting Therapy To Observe The Clinical Curative Effect Of Anastomotic Height

Objective:To explore the anastomotic location of the tissue-selecting therapy (TST) through comparision. To provide evidence of selection for clinical operations.Methods:A retrospective observation of 120 patients with mixed hemorrhoid who were accepted TST were carried out.According to the distance between anastomosis and dentate line, the patients were randomised into high anastomosis group (group A, 3 cm above dentate line), moderate anastomosis group (group B,2-3cm above dentate line) and low anastomosis group (group C,2cm off dentate line). There were 40 cases in each group. Anastomotic bleeding, operation time, postoperative anal edge number of incision, surgery anal pain on the first day, while were observed JiBian feeling, recral tenesmus, urination dysfunction, postoperative bleeding and so on. Using SPSS 19.0 with bilateral inspection for alpha= 0.05 level, we compared clinical effection.Results:There were statistical difference in anastomotic bleeding, postoperative anal edge number of incision, surgery anal pain on the first day, JiBian feeling and recral tenesmus(P<0.05). While,there was no statistical difference in operation time, urination dysfunction, postoperative bleeding and therapeutic evaluation(P<0.05).Conclusion:High anastomosis, anastomosis was far away from dentate line. The opration caused less nerve and vascular damage above dentate line. Complications, such as anastomotic bleeding, JiBian feeling, recral tenesmus were mild. However, the anastomotic position was too high to satisfy elevation of anal cushion. The remaining haemorrhoids were required to excised by external strip technique. Postoperative anal limbus incision and anal pain were more apparent. Moderate anastomosis,anastomosis was moderate from dentate line. The opration caused unapparent anal cushion’s tissue damage above dentate line. Complications, such as anastomotic bleeding, JiBian feeling, recral tenesmus were milder. Besides, the anastomotic position was moderate to satisfying elevation of anal cushion. The remaining haemorrhoids which were required to excised by Milligan-morgan therapy were few.postoperative anal limbus incision and anal pain were less apparent.Low anastomosis,anastomosis was near dentate line. The opration caused nerve and vascular damage above dentate line. Because anastomotic nail which stimulated sensory nerve nearby stayed in the tissue for a long time, complications, such as anastomotic bleeding, JiBian feeling, recral tenesmus were obvious. It reduced quality of life.However,elevation of anal cushion was best satisfying among three operation ways. There were few remaining haemorrhoid. Postoperative anal limbus incision and anal pain were less apparent. Above all, anastomotic location was set on 2 to 3 cm above dentate line was reasonable in TST.