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Evaluation of the clinical efficacy and safety of TST33 mega hemorrhoidectomy for severe prolapsed hemorrhoids

BACKGROUND: The pathogenesis of hemorrhoids is mainly anal cushion prolapse. Although the traditional treatment has a certain curative effect, it is not ideal. The remission rate of postoperative symptoms is low. Even if temporary remission is achieved, patients with hemorrhoids easily relapse after...

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Autores principales: Tao, Liu, Wei, Jun, Ding, Xu-Feng, Ji, Li-Jiang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9254172/
https://www.ncbi.nlm.nih.gov/pubmed/35949822
http://dx.doi.org/10.12998/wjcc.v10.i18.6060
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author Tao, Liu
Wei, Jun
Ding, Xu-Feng
Ji, Li-Jiang
author_facet Tao, Liu
Wei, Jun
Ding, Xu-Feng
Ji, Li-Jiang
author_sort Tao, Liu
collection PubMed
description BACKGROUND: The pathogenesis of hemorrhoids is mainly anal cushion prolapse. Although the traditional treatment has a certain curative effect, it is not ideal. The remission rate of postoperative symptoms is low. Even if temporary remission is achieved, patients with hemorrhoids easily relapse after 1-2 years. The new technique of using staplers to treat prolapsed hemorrhoids has good therapeutic effects in clinical practice. AIM: To explore the effect of TST33 mega stapler prolapse and hemorrhoid mucosal resection in the treatment of patients with severe prolapsed hemorrhoids. METHODS: A total of 204 patients with severe prolapse hemorrhoids who were admitted to the department of anorectal in our hospital from April 2018 to June 2020 were selected, and the patients were randomly divided into group A and group B with 102 cases in each group using a randomized controlled clinical research program. Patients in Group A were treated with a TST33 mega stapler and hemorrhoid mucosal resection to treat prolapse, and patients in Group B were treated according to the Procedure for Prolapse and Hemorrhoids; the operation time, intraoperative blood loss, hospital stay, the difference in operation time, intraoperative blood loss, hospitalization time, pain degree before and after operation, degree of anal edema, anal Wexner score, and surgical complications were compared between the two groups of patients. RESULTS: The operation time, intraoperative blood loss and hospitalization time in Group A were significantly lower than those in Group B (P < 0.05). The cure rate of Group A was 98.04%, compared with 95.10% cure rate of Group B, and the difference was not statistically significant (P > 0.05). The visual analogue scale (VAS) at 12 h and 24 h postoperatively in Group A were significantly lower than those in Group B (P < 0.05). The comparison of the VAS scores between Group A and Group B at 48 h, 72 h and 96 h postoperatively revealed that the difference was not statistically significant (P > 0.05). One day postoperatively, the degree of perianal edema in Group A was compared with that in Group B, and the difference was not statistically significant (P > 0.05). Seven days postoperatively, the degree of perianal edema in Group A was significantly lower than that in Group B (P < 0.05). The comparison of anal Wexner scores between the two groups preoperatively and at 1 mo, 3 mo and 6 mo postoperatively showed that the difference was not statistically significant (P > 0.05). The Wexner scores of the two groups at 1 mo, 3 mo and 6 mo postoperatively were significantly lower than the scores preoperatively (P < 0.05). The postoperative complication rate of Group A was 2.94% lower than that of Group B (11.76%), which was statistically significant (P < 0.05). CONCLUSION: TST33 mega anastomotic hemorrhoidectomy treatment for patients with severe prolapse hemorrhoids, leads to less postoperative pain, the rapid recovery of perianal edema and has fewer complications.
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spelling pubmed-92541722022-08-09 Evaluation of the clinical efficacy and safety of TST33 mega hemorrhoidectomy for severe prolapsed hemorrhoids Tao, Liu Wei, Jun Ding, Xu-Feng Ji, Li-Jiang World J Clin Cases Randomized Controlled Trial BACKGROUND: The pathogenesis of hemorrhoids is mainly anal cushion prolapse. Although the traditional treatment has a certain curative effect, it is not ideal. The remission rate of postoperative symptoms is low. Even if temporary remission is achieved, patients with hemorrhoids easily relapse after 1-2 years. The new technique of using staplers to treat prolapsed hemorrhoids has good therapeutic effects in clinical practice. AIM: To explore the effect of TST33 mega stapler prolapse and hemorrhoid mucosal resection in the treatment of patients with severe prolapsed hemorrhoids. METHODS: A total of 204 patients with severe prolapse hemorrhoids who were admitted to the department of anorectal in our hospital from April 2018 to June 2020 were selected, and the patients were randomly divided into group A and group B with 102 cases in each group using a randomized controlled clinical research program. Patients in Group A were treated with a TST33 mega stapler and hemorrhoid mucosal resection to treat prolapse, and patients in Group B were treated according to the Procedure for Prolapse and Hemorrhoids; the operation time, intraoperative blood loss, hospital stay, the difference in operation time, intraoperative blood loss, hospitalization time, pain degree before and after operation, degree of anal edema, anal Wexner score, and surgical complications were compared between the two groups of patients. RESULTS: The operation time, intraoperative blood loss and hospitalization time in Group A were significantly lower than those in Group B (P < 0.05). The cure rate of Group A was 98.04%, compared with 95.10% cure rate of Group B, and the difference was not statistically significant (P > 0.05). The visual analogue scale (VAS) at 12 h and 24 h postoperatively in Group A were significantly lower than those in Group B (P < 0.05). The comparison of the VAS scores between Group A and Group B at 48 h, 72 h and 96 h postoperatively revealed that the difference was not statistically significant (P > 0.05). One day postoperatively, the degree of perianal edema in Group A was compared with that in Group B, and the difference was not statistically significant (P > 0.05). Seven days postoperatively, the degree of perianal edema in Group A was significantly lower than that in Group B (P < 0.05). The comparison of anal Wexner scores between the two groups preoperatively and at 1 mo, 3 mo and 6 mo postoperatively showed that the difference was not statistically significant (P > 0.05). The Wexner scores of the two groups at 1 mo, 3 mo and 6 mo postoperatively were significantly lower than the scores preoperatively (P < 0.05). The postoperative complication rate of Group A was 2.94% lower than that of Group B (11.76%), which was statistically significant (P < 0.05). CONCLUSION: TST33 mega anastomotic hemorrhoidectomy treatment for patients with severe prolapse hemorrhoids, leads to less postoperative pain, the rapid recovery of perianal edema and has fewer complications. Baishideng Publishing Group Inc 2022-06-26 2022-06-26 /pmc/articles/PMC9254172/ /pubmed/35949822 http://dx.doi.org/10.12998/wjcc.v10.i18.6060 Text en ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
spellingShingle Randomized Controlled Trial
Tao, Liu
Wei, Jun
Ding, Xu-Feng
Ji, Li-Jiang
Evaluation of the clinical efficacy and safety of TST33 mega hemorrhoidectomy for severe prolapsed hemorrhoids
title Evaluation of the clinical efficacy and safety of TST33 mega hemorrhoidectomy for severe prolapsed hemorrhoids
title_full Evaluation of the clinical efficacy and safety of TST33 mega hemorrhoidectomy for severe prolapsed hemorrhoids
title_fullStr Evaluation of the clinical efficacy and safety of TST33 mega hemorrhoidectomy for severe prolapsed hemorrhoids
title_full_unstemmed Evaluation of the clinical efficacy and safety of TST33 mega hemorrhoidectomy for severe prolapsed hemorrhoids
title_short Evaluation of the clinical efficacy and safety of TST33 mega hemorrhoidectomy for severe prolapsed hemorrhoids
title_sort evaluation of the clinical efficacy and safety of tst33 mega hemorrhoidectomy for severe prolapsed hemorrhoids
topic Randomized Controlled Trial
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9254172/
https://www.ncbi.nlm.nih.gov/pubmed/35949822
http://dx.doi.org/10.12998/wjcc.v10.i18.6060
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