Clinical Study On The Height And Depth Of Purse Suture In Mixed Hemorrhoid TST

Objective:To explore the effect of the choice of the dentate line of the purse-string suture height and the depth of the purse-string suture on the clinical efficacy of the mixed hemorrhoids in TST.Methods:The clinical data of 278 patients with mixed hemorrhoids treated with TST in the First Affiliated Hospital of Xinjiang Medical University from January 2016 to December 2018 were retrospectively analyzed.They are divided into two groups according to the height of the purse stitching:The height of purse-string suture in group A was 1.5 cm to 2.5 cm on the dentate line,a total of 121 cases,and group B patients were 2.5 cm to 4.0 cm on the dentate line,a total of 157 cases.The pathological examination results of the surgically removed specimens were divided into two groups:In the pathological results of patients in the a group,the muscle layer was seen,indicating that the purse-string suture depth reached the rectal wall muscle layer,a total of 148 cases.The pathological results of the ? group showed no muscle layer,indicating that the purse-string suture only reached the submucosal layer,a total of 130 cases.The intraoperative conditions and postoperative complications of each group were observed from two groups.The patients were followed up for 1 to 5 months.Results:There were no significant differences in the cure rate(98.35%and 96.82%respectively),operation time,intraoperative blood loss,intraoperative suture anastomotic active bleeding,and postoperative bleeding between group A and group B(both P>0.05).The postoperative pain score of group A was higher than that of group B,and the difference was statistically significant(P<0.05).The incidence of postoperative anal edema and anal bulge discomfort in group A was significantly lower than that in group B(P<0.05).There were no significant differences in the cure rate(97.97%and 96.92%respectively),operation time and postoperative pain score between the a group and the ? group(both P>0.05).The intraoperative blood loss,the number of intraoperative sutures and anastomotic bleeding,and the postoperative blood loss were lower in the a group than in the ? group(P<0.05).The incidence of postoperative anal edema and anal bulge discomfort in patients in the a group was significantly lower than that in the ? group,and the difference was statistically significant(P<0.05).Conclusions:In the TST,the height of the purse is reduced from 1.5 cm to 2.5 cm from the dentate line,which can effectively reduce the incidence of postoperative anal edema and anal bulge discomfort.The suspending effect is good,but the postoperative pain is obvious.The depth of the purse should be sutured to the lower rectal mucosa,which can reduce bleeding and postoperative complications.