ObjectiveTo evaluate the safety of shearing fracture ligation combining procedure for prolapse and hemorrhoids （PPH） in treatment for mixed hemorrhoids via a multicenter clinical study. MethodsTwo hundred and fortysix patients with mixed hemorroids were included from four a level of firstclass hospitals, which were averagely divided into shearing fracture ligation combining PPH group, PPH group, and shearing fracture ligation group according to the order of admission. The occurrence status of rectovaginal fistula, urethrorectal fistula, postoperative bleeding, acute urinary retention, anorectal stenosis, and anal incontinence were observed. And the anal function was evaluated by the anorectal pressure measurement. ResultsNo rectovaginal fistula or urethrorectal fistula happened among three groups. No anorectal stenosis happened in the shearing fracture ligation combining PPH group or the PPH group. The score of anorectal stenosis and anal incontinence in these two groups were lower than those in the shearing fracture ligation group (Plt;0.05). The rate of postoperative bleeding in the shearing fracture ligation combining PPH group was lower than that in the shearing fracture ligation group (Plt;0.05). There were acute urinary retentions happened among three groups, but without significant differences among them (Pgt;0.05). The anal canal resting pressure after operation was lower than that before operation among three groups (Plt;0.01), which in the shearing fracture ligation combining PPH group was lower than that in the shearing fracture ligation group after operation (Plt;0.05). There were no significant differences of the rectum feeling capacity or maximum rectum capacity between the shearing fracture ligation combining PPH group and PPH group before and after operation (Pgt;0.05), but compared with the level before operation in the shearing fracture ligation group, the rectum feeling capacity obviously decreased after operation (Plt;0.05), the maximum rectum capacity obviously increased (Plt;0.05). There were no significant differences of the maxinum anal canal systolic blood pressure between before and after operation in three groups and among three groups (Pgt;0.05). ConclusionsThe operation of shearing fracture ligation combined with PPH can protect the tissue of rectal cushion, remain the normal anatomy structure of anal canal. It has better clinical effect and is much safer than other methods.
ObjectiveTo investigate the effect of external dissection and internal ligation, plus partial internal sphincterotomy in the treatment of mixed hemorrhoids. MethodsDuring January 2010 to January 2012, 364 patients with mixed hemorrhoids selected for surgery were divided into two groups based on whether the patients should accept the treatment of partial internal sphincterotomy. We observed the curative effect of the two groups, including anal pain, bleeding, edema, average healing days and the anorectal stenosis after operation. ResultsThere were statistical differences between the two groups in terms of anal pain, complication rate and hospital stay (P<0.01). The curative effect of the group treated with partial internal sphincterotomy was better than that of the other group. ConclustionExternal dissection and internal ligation, plus partial internal sphincterotomy is a better choice in the treatment of mixed hemorrhoids, which can relieve postoperative symptoms, reduce complications and shorten treatment course.
ObjectiveTo observe the efficacy of "Fuchuang Xunxi Formula" at different concentrations on patients after mixed hemorrhoidectomy. MethodsTwo hundred and ten patients having undergone mixed hemorrhoidectomy between October and November 2013 were randomized into seven groups, with 30 patients in each group. Group A was treated with 6% "Fuchuang Xunxi Formula"; Group B was treated with 6% "Zhiji Fumigation Formula"; Group C was treated with 4% "Fuchuang Xunxi Formula"; Group D was treated with 4% "Zhiji Fumigation Formula"; Group E was treated with 3% "Fuchuang Xunxi Formula"; Group F was treated with 3% "Zhiji Fumigation Formula"; And Group G was treated with branch water. Each group was fumigated at 45℃ for five minutes, then hip bath at 40℃ for five minutes with a course of 10 days. The curative effect of pain of wound, edema, effusion, urinary disturbance were observed. ResultsThe therapeutic effect in group C was the best (P<0.05), and the relief of postoperative complications (pain, edema, effusion) was better than the other groups (P<0.05). ConclusionTreatment with 4% "Fuchuang Xunxi Formula" for postoperative complications is the most effective.
Objective To compare the postoperative anorectal pressure after procedure for prolapse and hemorrhoids (PPH) and Milligan-Morgan hemorrhoidectomy (MMH) in treatment of patients with mixed hemorrhoid of Ⅲ-degree. Methods In total of 112 patients with mixed hemorrhoid of Ⅲ-degree who underwent PPH (n=60) or MMH (n=52) in The First Affiliated Hospital of Xinjiang Medical University between March 2014 to March 2015 were prospectively enrolled, the type of surgery was according to patients’ individual choice. In 6 months after operation, all patients under-went the examination of anorectal manometry which including rectal anal inhibitory reflex, rectal resting pressure, anal resting pressure, maximal anal contractive pressure, and anal canal length of high pressure belt. Results In 6 months after operation, the positive rate of rectal anal inhibitory reflex 〔88.3% (53/60) vs. 61.5% (32/52)〕 , anal resting pressure 〔(56.42± 2.25) mm Hg vs. (46.31±2.58) mm Hg〕, and anal canal length of high pressure belt 〔(3.35±0.12) cm vs. (2.29±0.23) cm〕 of PPH group were all significantly higher than those of MMH group (P＜0.05), but there was no statistical significance between PPH group and MMH group in rectal resting pressure 〔(5.51±1.26) mm Hg vs. (5.39±1.85) mm Hg〕 and maximal anal contractive pressure 〔(156.64±9.78) mm Hg vs. (155.32±8.53) mm Hg〕, P>0.05. Conclusion PPH and MMH are all effective to treat mixed hemorrhoids of Ⅲ-degree, but PPH is more positive in protection of anal function.