The Clinical Study Of Tissue Subtotaling Therapy Stapler On The Influence Of Anal Cushions Hemodynamics

Objective:Tissue subtotaling therapy stapler is a surgical procedure that inherits the thought "protect anal function" 、 "retain tissues and reduce injury" of traditional Chinese medicine and combines the traditional "piecewise" ligation therapy with the modern stapler technology.It has a significant clinical effect on the treatment of circular mixed hemorrhoids.It is believed that the main mechanism of action is "blockage of the blood flow","capacity reduction","suspension",and so on.The topic aimed to compare tissue subtotaling therapy stapler combine with external hemorrhoids excision with the commonly used operation--internal ligation and external incision in the clinical efficacy,anal cushion hemodynamics and the postoperative complications,to further explore the theoretical mechanism of blocking anal cushion blood flow by tissue subtotaling therapy stapler surgery.To provide a more effective method for the treatment of circular mixed hemorrhoids.Methods:Select 60 patients with circular mixed hemorrhoids were randomly divided into treatment group and control group according to the random number table method,30 cases each.The treatment group were treated with tissue subtotaling therapy stapler combine with external hemorrhoids excision,and the control group were treated with Ruiyun Procedure for Hemorrhoids(RPH)combined with external hemorrhoids excision respectively.Observe and record clinical efficacy,anal cushions hemodynamics and postoperative complications of the two groups of patients.Statistic and analyse the data of the two groups of patients.Results:1.Clinical efficacy: The effective rate was 100% in the treatment group and the control group at two months after operation,and there was no significant difference between the two groups(P>0.05).2.Changes in the hemodynamics of the cushions zone:(1).There was no significant difference in the number of internal hemorrhoids between the two groups before surgery(P>0.05),while the number of them in both groups was significantly reduced after surgery,and the control group was less than the treatment group,with statistical difference(P<0.05).(2).There was no significant difference in the number of arterial branches between the two groups before surgery(P>0.05),while the number of them in both groups was significantly reduced after surgery,and the control group was less than the treatment group,with statistical difference(P<0.05).(3)There were no significant differences in the hemodynamic indexes: PSV,EDV,RI and PI between the two groups(P>0.05).All the indicators in the two groups decreased after the operation(P<0.05).The control group was superior to the treatment group(P<0.05),which was statistically significant.3.Postoperative complications:(1)In terms of the postoperative anus pain here was no statistical differences between the two groups at 24 hours postoperatively and at the first defecation after the operation(P>0.05).The pain was statistically different between the two groups at the first week after the operation(P<0.05).The treatment group was better than the control group.(2)In the comparison of perianal edema and postoperative bleeding aspects of the situation within 1 month after operation,there was significant difference between the two groups(P<0.05).The treatment group is significantly superior to the control group.(3)There was no anal stenosis after operation in both groups.There was no significant difference in the size of postoperative anal caliber between the two groups(P>0.05).Conclusions:Although tissue subtotaling therapy stapler combine with external hemorrhoids excision is not as direct as internal ligation combine with external hemorrhoids excision on blocking the blood flow of anal cushions.In the case of the almost identical effect between the two kinds of operation,tissue subtotaling therapy stapler combine with external hemorrhoids not only ensures the integrity of the anal cushions,maintains the normal shape and compliance of the anus and rectum,but also eases the postoperative complications.It fully reflects the thoughts "protect anal function " and "retain tissues and reduce injury" of traditional Chinese medicine.It is worthy of further clinical promotion.