원형 자동 문합기 치핵절제술의 임상적 유용성
Clinical Effectiveness of a Circular Stapled Hemorrhoidectomy
윤성현, 민병소, 강중구,
소속 상세정보
윤성현 ( Yoon Seong-Hyeon )
국민건강보험공단 일산병원 외과
민병소 ( Min Byung-Soh )
연세대학교 의과대학 외과학교실
강중구 ( Kang Jung-Gu )
국민건강보험공단 일산병원 외과
KMID : 0356720040200010032
Abstract
Purpose: The circular stapled hemorrhoidectomy established by A. Longo involves reducing the mucous membrane prolapse and blocking the end branches of the upper hemorrhoidal artery through transverse incision of a suitable section of the mucosa between the rectum and the anal canal. This study was undertaken to determine the efficacy and the safety of a circular stapled hemorrhoidectomy by comparing it with a conventional Milligan-Morgan hemorrhoidectomy.
Methods: One hundred thirty (130) patients with prolapsed hemorrhoids underwent surgical treatment with either a conventional (n=66)(conventional group) or a circular stapled (n=64) (stapled group) hemorrhoidectomy. The operation time was recorded, and the resected specimen was examined. The patients assessed their postoperative pain. Time to first bowel movement, hospital stay, and postoperative complications were analyzed. All patients received follow-up examinations at the out-patient clinic, and the time to return to work and the degree of their satisfaction were checked.
Results: The stapled group had a shorter average operation time (19.2 min. vs 26.1 min., P=0.016). The postoperative pain score in the stapled group was significantly lower than it was in the conventional group (P＜0.05). Time to first bowel movement and hospital stay were not significantly different between the groups. Return to work was significantly faster in the stapled group (6.5 days vs 15.8 days, P＜0.05). The degrees of satisfaction for the two groups were similar, and postoperative complications in the two groups were both similar and acceptable (6.1% vs 11.0%, P＞0.05).
Conclusions: A circular stapled hemorrhoidectomy offers a significantly less painful alternative to the conventional technique and is associated with an earlier return to normal activity. However, the long-term outcome needs to be evaluated further. J Korean Soc Coloproctol 2004;20:32-38
키워드
치핵;스테이플
Hemorrhoids; Staple
원문 및 링크아웃 정보
등재저널 정보