Cushion-Preserving Plastic Surgery Combined with PPH in the Treatment of Grade Ⅲ and Grade Ⅳ Mixed Hemorrhoids and Its Effect on Anal Function
WU Wei,NINGYu-yong,ZHANG Yu
Department of Anorectal Surgery, General Hospital of Wanbei Coal Power Group, Suzhou 234000, China
Abstract:
Objective To explore the effect of anal cushion-preserving plastic surgery combined with PPH in the treatment of grade III and IV mixed hemorrhoids and its influence on anal function. Methods 92 patients with severe mixed hemorrhoids were randomly divided into control group (n=46) and observation group (n=46). The control group was treated with Milligan-Morgan operation and the observation group was treated with anal pad-preserving plastic surgery combined with PPH.The general data of the two groups were compared; the postoperative conditions of the two groups were compared; the clinical effects of the two groups were compared; the preoperative and postoperative anal function scores of the two groups were compared and evaluated by random walking model; the postoperative complications of the two groups were compared; the survival curve was drawn by Kaplan-Meier method, and the non-recurrence rate of the two groups during the 1-year follow-up period was compared. Results The operation time of the control group and the observation group was (47.06±3.87) min and (38.64±5.12) min, the intraoperative blood loss was (45.18±7.42) mL and (25.31±4.05) mL respectively, and the hospital stay was (8.12±1.53) days and (5.62±1.37) days.The pain VAS scores were (5.34±1.32) points and (4.48±1.40) points at 24h postoperatively, and the durations of first defecation pain were (34.15±5.43) min and (24.25±4.28) minrespectively.The edema time was (4.96±1.18) d and (3.51±0.78) d, and the blood-bearing time was (5.53±0.82) d and (4.02±0.74) d, respectively. The total effective rates of treatment were 67% and 96% respectively. The postoperative non-recurrence rates were 37% and 87% respectively. The Wexner total score of anal function at the 14th day after surgery increased significantly, which were (10.42±1.85) points and (8.42±1.78) points respectively. The differences were statistically signi?cant (P<0.05). Conclusion Anal cushion-preserving plastic surgery combined with PPH for the treatment of mixed hemorrhoids of grade III
