治疗混合痔的内窥镜带状结扎术和硬化疗法与米利根-摩根痔疮切除术的比较

IF 1.2 Q4 GASTROENTEROLOGY & HEPATOLOGY

Techniques and Innovations in Gastrointestinal Endoscopy Pub Date : 2025-01-01 DOI:10.1016/j.tige.2025.250914

Minghua Ai , Weizheng Wang , Jie Li , Xiaoping Tan , Qing Zhang

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引用次数: 0

摘要

背景和目的比较内镜下带状结扎联合硬化剂注射（EBS）与米利根-摩根痔切除术（MMH）治疗混合痔的临床疗效。自2022年9月至2023年3月，46名接受EBS治疗混合痔的患者被选入观察组，32名接受MMH治疗混合痔的患者被分配到对照组。结果观察组的手术时间和住院时间明显短于对照组（P <0.05）。此外，两组的术后视觉模拟量表评分均有所下降，观察组在术后 24 小时、48 小时和 1 周的评分持续较低（P < 0.05）。此外，观察组在术后 4 小时的视觉模拟量表评分与使用的内窥镜结扎带数量相关（R2 = 0.1253；P = 0.0158）。两组患者在术后肛门肿胀、总体疗效或患者满意度方面无明显差异（均为 P > 0.05）。然而，观察组的术中出血量（0% vs 84.4%；P = 0.000）和术后出血量（6.5% vs 34.4%；P = 0.002）明显少于对照组，术后感染率（0% vs 9.4%；P = 0.034）也低于对照组。此外，EBS 方法可能是一种创伤更小、时间更短的手术方法，住院时间相对缩短，并发症风险更低，恢复更快。

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Endoscopic Band Ligation With Sclerotherapy Versus Milligan–Morgan Hemorrhoidectomy for the Treatment of Mixed Hemorrhoids

BACKGROUND AND AIMS

To compare the clinical efficacy of endoscopic band ligation with sclerotherapy (EBS) with that of Milligan–Morgan hemorrhoidectomy (MMH) in the treatment of mixed hemorrhoids.

METHODS

This study was a retrospective, single-center investigation conducted at the First Hospital of Yangtze University. From September 2022 to March 2023, 46 patients who underwent EBS for mixed hemorrhoids were selected in an observation group, whereas 32 patients who underwent MMH for mixed hemorrhoids were allocated to a control group. Surgical-related parameters and adverse events were compared between the 2 groups, and the relationship between the number of endoscopic bands used and pain levels was analyzed.

RESULTS

The observation group demonstrated significantly shorter surgical and hospitalization durations than the control group (P < 0.05). Furthermore, the 2 groups showed decreased postoperative visual analog scale scores, with the observation group exhibiting consistently lower scores at 24 hours, 48 hours, and 1 week postoperatively (P < 0.05). Additionally, visual analog scale scores in the observation group at 4 hour postsurgery were correlated with the number of endoscopic ligation bands applied (R² = 0.1253; P = 0.0158). No significant differences in postoperative anal swelling, overall efficacy, or patient satisfaction were observed between the 2 groups (all P > 0.05). However, the observation group experienced significantly less intraoperative (0% vs 84.4%; P = 0.000) and postoperative bleeding (6.5% vs 34.4%; P = 0.002) and a lower postoperative infection rate (0% vs 9.4%; P = 0.034) than the control group.

CONCLUSION

EBS provides clinical efficacy comparable with that of MMH in the treatment of mixed hemorrhoids. Moreover, the EBS approach is a potentially less invasive and shorter surgical procedure with relatively reduced hospitalization time, lower complication risk, and faster recovery.

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来源期刊

Techniques and Innovations in Gastrointestinal Endoscopy Medicine-Gastroenterology

CiteScore

2.10

自引率

50.00%

发文量