The comparison of doppler-guided haemorrhoidal artery ligation and the tissue selecting technique for patients with grade III/IV haemorrhoids: a retrospective cohort study.

IF 2.4 3区 医学 Q2 SURGERY
Xiaojun Liu, Liangxian Jiang, Weilin Wang
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引用次数: 0

Abstract

This study aimed to evaluate the efficacy and the safety of Doppler-guided hemorrhoid artery ligation (DG-HAL) and tissue-selecting technique (TST) in patients with grade III/IV hemorrhoids. We conducted a retrospective analysis of 251 patients with grade III/IV hemorrhoids between January 2019 and January 2021. Among them, 119 patients had received TST, and the remaining 132 patients received DG-HAL. We collected and compared clinical characteristics of both groups, including post-operative visual analog scale (VAS) for pain, post-operative bleeding, post-operative defecation, urinary retention, and recurrence rate (prolapse and bleeding). The VAS pain score of the first post-operative defecation and at the post-operative day (POD)1 and 2 for the DG-HAL group was lower than those for the TST group (P = 0.006 and P = 0.029). The incidence of post-operative complications (including bleeding, urinary retention and sensation of rectal tenesmus) in the DG-HAL group was lower than that in the TST group (P = 0.021, P = 0.035 and P = 0.047). At follow-up by telephone or outpatient 3 years after surgery, the recurrence rate (prolapse) was lower in the TST group than in the DG-HAL group (P = 0.013). Subgroup analysis showed a higher prolapse recurrence rate in grade IV patients than grade III patients after DG-HAL (P = 0.013). DG-HAL had fewer complications, lower bleeding rates, and less early post-operative pain but showed a higher recurrence rate than TST at the 3-year follow-up, especially in grade IV patients.

多普勒引导下痔动脉结扎与组织选择技术治疗III/IV级痔疮的回顾性队列研究
本研究旨在评价多普勒引导下痔动脉结扎术(DG-HAL)和组织选择技术(TST)在III/IV级痔疮患者中的疗效和安全性。我们对2019年1月至2021年1月期间251例III/IV级痔疮患者进行了回顾性分析。其中接受TST治疗的119例,接受DG-HAL治疗的132例。我们收集并比较两组患者的临床特征,包括术后疼痛、术后出血、术后排便、尿潴留和复发率(脱垂和出血)的视觉模拟量表(VAS)。DG-HAL组术后第一次排便及术后第1、2天VAS疼痛评分均低于TST组(P = 0.006、P = 0.029)。DG-HAL组术后并发症(出血、尿潴留、直肠下坠感)发生率低于TST组(P = 0.021、P = 0.035、P = 0.047)。术后3年电话随访或门诊随访,TST组脱垂复发率低于DG-HAL组(P = 0.013)。亚组分析显示,DG-HAL术后IV级患者脱垂复发率高于III级患者(P = 0.013)。DG-HAL并发症少,出血率低,术后早期疼痛少,但在3年随访中,复发率高于TST,特别是在IV级患者中。
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来源期刊
Updates in Surgery
Updates in Surgery Medicine-Surgery
CiteScore
4.50
自引率
7.70%
发文量
208
期刊介绍: Updates in Surgery (UPIS) has been founded in 2010 as the official journal of the Italian Society of Surgery. It’s an international, English-language, peer-reviewed journal dedicated to the surgical sciences. Its main goal is to offer a valuable update on the most recent developments of those surgical techniques that are rapidly evolving, forcing the community of surgeons to a rigorous debate and a continuous refinement of standards of care. In this respect position papers on the mostly debated surgical approaches and accreditation criteria have been published and are welcome for the future. Beside its focus on general surgery, the journal draws particular attention to cutting edge topics and emerging surgical fields that are publishing in monothematic issues guest edited by well-known experts. Updates in Surgery has been considering various types of papers: editorials, comprehensive reviews, original studies and technical notes related to specific surgical procedures and techniques on liver, colorectal, gastric, pancreatic, robotic and bariatric surgery.
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