Clinical Study Of Tissue-Selecting Therapy Stapler Combined With External Hemorrhoidectomy In The Treatment Of Mixed Hemorrhoids Of Grade ? And ?

Objective:To evaluate the clinical efficacy and safety of Tissue-Selecting Therapy stapler with external hemorrhoidectomy and milligan-morgan hemorrhoidectomy in the treatment of grade III and IV mixed hemorrhoids.Methods:130 patients with grade III-IV mixed hemorrhoids who met the inclusion criteria were randomly divided into treatment group and control group,65 cases in each group.The treatment group was treated with Tissue-Selecting Therapy stapler with external hemorrhoids stripping,while the control group was treated with milligan-morgan hemorrhoidectomy.The blood volume,operation time,pain,hemorrhage,edema and defecation on the first,third,seventh and fourteenth day after operation,anal stenosis,anal defecation control function on the 2^thmonths,and total wound healing time,hospitalization expenses,hospitalization days,hospitalization satisfaction and anxiety during hospitalization were observed and recorded.Results:?1?There was no significant difference in operation time between the treatment group and the control group?p>0.05?.There was significant difference in intraoperative bleeding volume?p<0.05?.The result shows that treatment group was better than the control group.?2?There was no significant difference in pain score between the treatment group and the control group on the first day and the seventh day after operation?p>0.05?;there was significant difference in pain score on the third day and the fourteenth day after operation?p<0.05?,and the treatment group was better than the control group.In addition,the overall pain risk in the treatment group was lower than that in the control group?Wald Chi Square=17.578,p<0.05,OR=1.674?.Compared with the first day after operation,the risk of pain on the 3rd,7th and 14th day after operation in both groups decreased.?3?There was no statistical difference between the treatment group and the control group on the first and third day after operation?p>0.05?;there was significant statistical difference on the bleeding on the seventh and fourteenth day after operation?p<0.05?,and the treatment group was better than the control group.In addition,the overall risk of bleeding in the treatment group was lower than that in the control group?Wald Chi Square=51.677,p<0.05,OR=1.879?.Compared with the first day after operation,the risk of bleeding in the treatment group remained unchanged on the third day after operation,while the risk of bleeding on the seventh and fourteenth days decreased.The risk of bleeding remained unchanged on the third day,increased on the seventh day and decreased on the fourteenth day in the control group.?4?There was no significant difference in defecation between the treatment group and the control group on the first day,the third day,the seventh day and the fourteenth day after operation?p>0.05?;the overall risk of defecation in the treatment group was lower than that in the control group?Wald Chi-square=6.198,p<0.05,OR=1.554?.Compared with the first day after operation,the risk of dyspepsia gradually decreased on the third,seventh and fourteenth day after operation in both groups.?5?There was no significant difference in edema between the treatment group and the control group on the first and fourteenth day after operation?p>0.05?;there was significant difference in edema on the third and seventh day after operation?p<0.05?,and the treatment group was better than the control group.In addition,the overall risk of edema in the treatment group was lower than that in the control group?Wald Chi Square=29.999,p<0.05,OR=3.129?.Compared with the first day after operation,the risk of edema in the treatment group remained unchanged on the third day after operation,and decreased on the seventh and fourteenth day.The risk of edema remained unchanged on day 3,increased on day 7 and decreased on day 14 in the control group.?6?The total cost of discharge in treatment group and control group had statistical significance?p<0.05?,while that in control group was less than that in treatment group.The hospitalization days and discharge satisfaction scores in the treatment group were better than those in the control group?p<0.05?.?7?There was no significant difference in the anxiety score between the treatment group and the control group?p>0.05?.The overall healing time of the wound was statistically significant?p<0.05?.The treatment group was less than the control group.There was no significant difference in the overall efficacy between the two groups?p>0.05?.Conclusions:Compared with milligan-morgan hemorrhoidectomy,Tissue-Selecting Therapy staplery combined with external hemorrhoidectomy has no significant difference in the overall efficacy of treating III-IV mixed hemorrhoids,but it has obvious advantages in intraoperative pain and edema on the third day after operation,bleeding and edema on the seventh day after operation,bleeding and pain on the fourteenth day after operation.It is a safe and effective surgical method for the treatment of mixed hemorrhoids of grade III-IV.It has less bleeding,fewer complications and shorter hospitalization days after operation,which further improves the surgical experience of patients and is worthy of clinical promotion.