Clinical Therapeutic Research Of The Tissue Selecting Therapy Stapler(TST) In Treating Grade Ⅱ And Ⅲ Mixed Hemorrhoid

Objective:To investigate and compare the effect and safety of surgical procedures for the Tissue selecting therapy staplerpurese(TST)and Milligan-Morgan hemorrhoidectomy(MMH)in treating grade-III and IV mixed hemorrhoid through normative scientific research design.Methods:The clinical data of 140 hemorrhoid cases with grade-III and IV mixed hemorrhoid in our hospital were selected as our subjects and randomly divided into treatment group(TST)and control group(MMH),and each group contained 70 patients.The gender,age,course of disease,degree of mixed hemorrhoids,The operation time,intraoperative blood loss,postoperative pain(24h,3d,7d),postoperative urinary etention(24h),Edema of Crissum(3 d,7 d,10d),Number of suture required for active bleeding during operation,Number of exfoliated hemorrhage after operation(7-14d),hospital stay,hospitalization expenses,operative effect.anal bulge(1、2、3m)、Anus incontinence(1、2、3m),Anus stenosis(3 m)、Morphology and pathology of Excised tissue were compared between the two groups.ResultsTwo groups of gender,age,course of disease,degree of mixed hemorrhoids of general data,no significant difference(P > 0.05),with comparable.TST and MMH groups in all aspects of surgery recovery,there was no significant difference(P >0.05).TST group length of stay is shorter than MMH group,but higher cost.There had a statistical significance.The operation time,ostoperative pain(24 h,3 d),Edema of Crissum(3 d,7 d,10 d),Number of exfoliated hemorrhage after operation(7-14 d),anal bulge(1、2 m)between the two groups(P < 0.05).Through Morphology and pathology of Excised tissue,the resected tissue contains rectal mucosa tissue(weight and volume)in TST group were better than those have no muscle fiber in the TST group(P < 0.05).Thedepth of purse string suture to the rectal wall with slight muscle layer in TST may have some relationship with the incidence of Number of exfoliated hemorrhage after operation and blood rate.Conclusions:TST and MMH are safe and effective for the treatment of grade-III and IV mixed hemorrhoid.Compared with MMH,TST has some advantages in short-term effect,such as Shorter operation time,less intraoperative bleeding,less number of suture required for active bleeding during operation,shorter postoperative hospitalization,lower postoperative pain,lower incidence of edema of Crissum,lower incidence of anus distension and so on.