Objective:To observe the clinical effect of high suspension and low incision(HSLI)surgery on mixed haemorrhoids,compared with Milligan-Morgan haemorrhoidectomy.Methods:A multi-centre,randomized,singleblind,non-inferio...Objective:To observe the clinical effect of high suspension and low incision(HSLI)surgery on mixed haemorrhoids,compared with Milligan-Morgan haemorrhoidectomy.Methods:A multi-centre,randomized,singleblind,non-inferiority clinical trial was performed.Participants with mixed haemorrhoids from Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing Rectum Hospital,Air Force Medical Center of People's Liberation Army of China,and Puyang Hospital of Traditional Chinese Medicine were enrolled from September 2016 to March 2018.By using a blocked randomization scheme,participants were assigned to two groups.The experimental group was treated with HSLI,while the control group was treated with Milligan-Morgan haemorrhoidectomy.The primary outcome was the clinical effect evaluated at 12 weeks after operation.The secondary outcomes included the number of haemorrhoids treated during the operation,pain scores,use of analgesics,postoperative oedema,wound healing,incidence of anal stenosis,anorectal manometry after operation,as well as surgical duration,length of stay and total hospitalization expenses.A safety evaluation was also conducted.Results:In total,246 eligible participants were enrolled,with 123 cases in each group.There was no significant difference in the clinical effect between the two groups(100.00% vs.99.19%,P>0.05).Compared with the control group,the number of external haemorrhoids treated during the operation and the pain scores after operation were significantly reduced in the experimental group(P<0.05 or P<0.01);the patient number with wound healing at 2 weeks after operation and the functional length of anal canal at 12 weeks after operation were significantly increased in the experimental group(P<0.05).There was no significant difference in the incidence of anal stenosis,the numbers of patients using analgesics and patients with postoperative oedema between the two groups after operation(P>0.05).The surgical duration and length of stay in the experimental group were significantly longer than th展开更多
AIM:To demonstrate the value of Diosmin(flavonidic fraction)in the management of post-haemorhoidectomic symptoms.METHODS:Eighty-six consecutive patients with grades ⅢandⅣacute mixed hemorrhoids admitted to the Anore...AIM:To demonstrate the value of Diosmin(flavonidic fraction)in the management of post-haemorhoidectomic symptoms.METHODS:Eighty-six consecutive patients with grades ⅢandⅣacute mixed hemorrhoids admitted to the Anorectal Surgical Department of First Affiliated Hospital,Xinjiang Medical University from April 2009 to April 2010,were enrolled in this study.An observerblinded,randomized trial was conducted to compare post-haemorhoidectomic symptoms with use of Diosmin flavonidic fraction vs placebo.Eighty-six patients were randomly allocated to receive Diosmin flavonidic fraction 500 mg for 1 wk(n=43)or placebo(n=43).The Milligan-Morgan open haemorrhoidectomy was performed by a standardized diathermy excision method.Pain,bleeding,heaviness,pruritus,wound edema and mucosal discharge were observed after surgery.The postoperative symptoms and hospitalization time were recorded.RESULTS:The mean age of the Diosmin group and controls was 53.2 and 51.3 years,respectively.In Diosmin group,haemorrhoid piles were of the third degree in 33 patients and the fourth degree in 10;and in the control group,29 were of the third degree and 14 were of the fourth degree.There was no statistically significance in age,gender distribution,degree and number of excised haemorrhoid piles,and the mean duration of haemorrhoidal disease between the two groups.There was a statistically significant improvement in pain,heaviness,bleeding,pruritus from baseline to the 8th week after operation(P<0.05).Patients taking Diosmin had a shorter hospitalization stay after surgery(P< 0.05).There was also a significant improvement on the proctoscopic appearance(P<0.001).However,there was no statistical difference between the two groups in terms of wound mucosal discharge.Two patients experienced minor bleeding at the 8th week in Diosmin group,and underwent surgery.CONCLUSION:Diosmin is effective in alleviating postoperational symptoms of haemorrhoids.Therefore,it should be considered for the initial treatment after haemorrhoid surgery.However,further prospe展开更多
基金Supported by the Capital Featured Clinical Application and Promotion Project(No.Z151100004015082)Basic Research Business Fees Independent Selection Project of China Academy of Chinese Medical Sciences(No.ZZ0908002)Cultivation Project of National Natural Science Foundation of China in Xiyuan Hospital,China Academy of Chinese Medical Sciences(No.XY20-16)。
文摘Objective:To observe the clinical effect of high suspension and low incision(HSLI)surgery on mixed haemorrhoids,compared with Milligan-Morgan haemorrhoidectomy.Methods:A multi-centre,randomized,singleblind,non-inferiority clinical trial was performed.Participants with mixed haemorrhoids from Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing Rectum Hospital,Air Force Medical Center of People's Liberation Army of China,and Puyang Hospital of Traditional Chinese Medicine were enrolled from September 2016 to March 2018.By using a blocked randomization scheme,participants were assigned to two groups.The experimental group was treated with HSLI,while the control group was treated with Milligan-Morgan haemorrhoidectomy.The primary outcome was the clinical effect evaluated at 12 weeks after operation.The secondary outcomes included the number of haemorrhoids treated during the operation,pain scores,use of analgesics,postoperative oedema,wound healing,incidence of anal stenosis,anorectal manometry after operation,as well as surgical duration,length of stay and total hospitalization expenses.A safety evaluation was also conducted.Results:In total,246 eligible participants were enrolled,with 123 cases in each group.There was no significant difference in the clinical effect between the two groups(100.00% vs.99.19%,P>0.05).Compared with the control group,the number of external haemorrhoids treated during the operation and the pain scores after operation were significantly reduced in the experimental group(P<0.05 or P<0.01);the patient number with wound healing at 2 weeks after operation and the functional length of anal canal at 12 weeks after operation were significantly increased in the experimental group(P<0.05).There was no significant difference in the incidence of anal stenosis,the numbers of patients using analgesics and patients with postoperative oedema between the two groups after operation(P>0.05).The surgical duration and length of stay in the experimental group were significantly longer than th
基金Supported by The Biological Medical Engineering Foundation of First Affiliated Hospital of Xinjiang Medical University
文摘AIM:To demonstrate the value of Diosmin(flavonidic fraction)in the management of post-haemorhoidectomic symptoms.METHODS:Eighty-six consecutive patients with grades ⅢandⅣacute mixed hemorrhoids admitted to the Anorectal Surgical Department of First Affiliated Hospital,Xinjiang Medical University from April 2009 to April 2010,were enrolled in this study.An observerblinded,randomized trial was conducted to compare post-haemorhoidectomic symptoms with use of Diosmin flavonidic fraction vs placebo.Eighty-six patients were randomly allocated to receive Diosmin flavonidic fraction 500 mg for 1 wk(n=43)or placebo(n=43).The Milligan-Morgan open haemorrhoidectomy was performed by a standardized diathermy excision method.Pain,bleeding,heaviness,pruritus,wound edema and mucosal discharge were observed after surgery.The postoperative symptoms and hospitalization time were recorded.RESULTS:The mean age of the Diosmin group and controls was 53.2 and 51.3 years,respectively.In Diosmin group,haemorrhoid piles were of the third degree in 33 patients and the fourth degree in 10;and in the control group,29 were of the third degree and 14 were of the fourth degree.There was no statistically significance in age,gender distribution,degree and number of excised haemorrhoid piles,and the mean duration of haemorrhoidal disease between the two groups.There was a statistically significant improvement in pain,heaviness,bleeding,pruritus from baseline to the 8th week after operation(P<0.05).Patients taking Diosmin had a shorter hospitalization stay after surgery(P< 0.05).There was also a significant improvement on the proctoscopic appearance(P<0.001).However,there was no statistical difference between the two groups in terms of wound mucosal discharge.Two patients experienced minor bleeding at the 8th week in Diosmin group,and underwent surgery.CONCLUSION:Diosmin is effective in alleviating postoperational symptoms of haemorrhoids.Therefore,it should be considered for the initial treatment after haemorrhoid surgery.However,further prospe
