CAJ | 학술논문

目的探讨吻合器痔上黏膜环切钉合术(PPH)后围手术期及远期并发症的发生情况.方法回顾性分析2002年1月至2011年12月间第二炮兵总医院采用PPH治疗2152例环状内痔和环状混合痔病例的临床资料,统计围手术期及术后远期并发症发生情况.结果术后中位随访73个月,术后早期出现急性尿储留360例(16.7％),给予短时留置导尿处理;吻合口出血45例(2.1％),予以再次手术缝扎或镜下电凝、止血夹止血；肛门会阴部持续性疼痛30例(1.4％),给予局部对症或取出吻合钉处理；血栓性外痔形成28例(1.2％),给予保守治疗或行血栓性外痔剥离术治疗；所有患者均治愈.术后远期并发症包括轻度肛门失禁112例(6.3％),肛门坠胀和排粪急迫感50例(2.8％),予以保守治疗和功能锻炼,症状恢复;吻合口狭窄4例(0.2％),予以扩肛治疗后治愈.术后复发82例(4.6％),其中28例再次行PPH治愈；54例保守治疗后症状好转.结论 PPH治疗环状内痔和环状混合痔比较安全.
목적 탐토문합기치상점막배절정합술(PPH)후위수술기급원기병발증적발생정황.방법 회고성분석2002년1월지2011년12월간제이포병총의원채용PPH치료2152례배상내치화배상혼합치병례적림상자료,통계위수술기급술후원기병발증발생정황.결과 술후중위수방73개월,술후조기출현급성뇨저류360례(16.7％),급여단시류치도뇨처리;문합구출혈45례(2.1％),여이재차수술봉찰혹경하전응、지혈협지혈；항문회음부지속성동통30례(1.4％),급여국부대증혹취출문합정처리；혈전성외치형성28례(1.2％),급여보수치료혹행혈전성외치박리술치료；소유환자균치유.술후원기병발증포괄경도항문실금112례(6.3％),항문추창화배분급박감50례(2.8％),여이보수치료화공능단련,증상회복;문합구협착4례(0.2％),여이확항치료후치유.술후복발82례(4.6％),기중28례재차행PPH치유；54례보수치료후증상호전.결론 PPH치료배상내치화배상혼합치비교안전.
Objective To investigate the perioperative and postoperative long-term complications of procedure for prolapse and hemorrhoids (PPH) for the treatment of circular internal hemorrhoids and circular mixed hemorrhoids.Methods A retrospective study was performed in 2152 patients with circular internal hemorrhoids and circular mixed hemorrhoids eligible for PPH from January 2002 to December 2011.The perioperative and postoperative long-term complications were recorded and assessed.Results The median length of follow-up was 73 months.Perioperative complications and adverse events were reported including acute urinary retention (n=360,16.7％) which was managed by temporary cathether indwelling,anastomotic bleeding (n=45,2.1％) managed by surgical or endoscopic procedures,chronic anoperineal sustained pain (n=30,1.4％) managed by local treatment or stapler removal,and thrombosed external hemorrhoid (n=28,1.2％) managed by conservative treatment or resection.Long-term postoperative complications were reported including mild fecal incontinence(n=112,6.3％),postoperative recurrence(n=82,4.6％),anal distention and defecatory urgency(n=50,2.8％),anastomotic stenosis (n=4,0.2％).Postoperative recurrence developed in 82 patients (4.6％),28 of whom were managed by repeat PPH and 54 by conservative treatment.Conclusion PPH appears to be a safe technique for patients with circular internal hemorrhoids and circular mixed hemorrhoids.