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Procedure for prolapse and hemorrhoids vs traditional surgery for outlet obstructive constipation.
World J Gastroenterol. 2015 Jul 14; 21(26):8178-83.WJ

Abstract

AIM

To compare the clinical efficacies of two surgical procedures for hemorrhoid rectal prolapse with outlet obstruction-induced constipation.

METHODS

One hundred eight inpatients who underwent surgery for outlet obstructive constipation caused by internal rectal prolapse and circumferential hemorrhoids at the First Affiliated Hospital of Xinjiang Medical University from June 2012 to June 2013 were prospectively included in the study. The patients with rectal prolapse hemorrhoids with outlet obstruction-induced constipation were randomly divided into two groups to undergo either a procedure for prolapse and hemorrhoids (PPH) (n = 54) or conventional surgery (n = 54; control group). Short-term (operative time, postoperative hospital stay, postoperative urinary retention, postoperative perianal edema, and postoperative pain) and long-term (postoperative anal stenosis, postoperative sensory anal incontinence, postoperative recurrence, and postoperative difficulty in defecation) clinical effects were compared between the two groups. The short- and long-term efficacies of the two procedures were determined.

RESULTS

In terms of short-term clinical effects, operative time and postoperative hospital stay were significantly shorter in the PPH group than in the control group (24.36 ± 5.16 min vs 44.27 ± 6.57 min, 2.1 ± 1.4 d vs 3.6 ± 2.3 d, both P < 0.01). The incidence of postoperative urinary retention was higher in the PPH group than in the control group, but the difference was not statistically significant (48.15% vs 37.04%). The incidence of perianal edema was significantly lower in the PPH group (11.11% vs 42.60%, P < 0.05). The visual analogue scale scores at 24 h after surgery, first defecation, and one week after surgery were significantly lower in the PPH group (2.9 ± 0.9 vs 8.3 ± 1.1, 2.0 ± 0.5 vs 6.5 ± 0.8, and 1.7 ± 0.5 vs 5.0 ± 0.7, respectively, all P < 0.01). With regard to long-term clinical effects, the incidence of anal stenosis was lower in the PPH group than in the control group, but the difference was not significant (1.85% vs 5.56%). The incidence of sensory anal incontinence was significantly lower in the PPH group (3.70% vs 12.96%, P < 0.05). The incidences of recurrent internal rectal prolapse and difficulty in defecation were lower in the PPH group than in the control group, but the differences were not significant (11.11% vs 16.67% and 12.96% vs 24.07%, respectively).

CONCLUSION

PPH is superior to the traditional surgery in the management of outlet obstructive constipation caused by internal rectal prolapse with circumferential hemorrhoids.

Authors+Show Affiliations

Ming Lu, Bo Yang, Yang Liu, Qing Liu, Hao Wen, Department of General Surgery, First Affiliated Teaching Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China.Ming Lu, Bo Yang, Yang Liu, Qing Liu, Hao Wen, Department of General Surgery, First Affiliated Teaching Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China.Ming Lu, Bo Yang, Yang Liu, Qing Liu, Hao Wen, Department of General Surgery, First Affiliated Teaching Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China.Ming Lu, Bo Yang, Yang Liu, Qing Liu, Hao Wen, Department of General Surgery, First Affiliated Teaching Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China.Ming Lu, Bo Yang, Yang Liu, Qing Liu, Hao Wen, Department of General Surgery, First Affiliated Teaching Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

26185392

Citation

Lu, Ming, et al. "Procedure for Prolapse and Hemorrhoids Vs Traditional Surgery for Outlet Obstructive Constipation." World Journal of Gastroenterology, vol. 21, no. 26, 2015, pp. 8178-83.
Lu M, Yang B, Liu Y, et al. Procedure for prolapse and hemorrhoids vs traditional surgery for outlet obstructive constipation. World J Gastroenterol. 2015;21(26):8178-83.
Lu, M., Yang, B., Liu, Y., Liu, Q., & Wen, H. (2015). Procedure for prolapse and hemorrhoids vs traditional surgery for outlet obstructive constipation. World Journal of Gastroenterology, 21(26), 8178-83. https://doi.org/10.3748/wjg.v21.i26.8178
Lu M, et al. Procedure for Prolapse and Hemorrhoids Vs Traditional Surgery for Outlet Obstructive Constipation. World J Gastroenterol. 2015 Jul 14;21(26):8178-83. PubMed PMID: 26185392.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Procedure for prolapse and hemorrhoids vs traditional surgery for outlet obstructive constipation. AU - Lu,Ming, AU - Yang,Bo, AU - Liu,Yang, AU - Liu,Qing, AU - Wen,Hao, PY - 2014/11/30/received PY - 2015/02/02/revised PY - 2015/03/18/accepted PY - 2015/7/18/entrez PY - 2015/7/18/pubmed PY - 2016/3/24/medline KW - Internal rectal prolapse KW - Outlet obstructive constipation KW - Procedure for prolapse and hemorrhoids KW - Prospective study KW - Randomized controlled study SP - 8178 EP - 83 JF - World journal of gastroenterology JO - World J Gastroenterol VL - 21 IS - 26 N2 - AIM: To compare the clinical efficacies of two surgical procedures for hemorrhoid rectal prolapse with outlet obstruction-induced constipation. METHODS: One hundred eight inpatients who underwent surgery for outlet obstructive constipation caused by internal rectal prolapse and circumferential hemorrhoids at the First Affiliated Hospital of Xinjiang Medical University from June 2012 to June 2013 were prospectively included in the study. The patients with rectal prolapse hemorrhoids with outlet obstruction-induced constipation were randomly divided into two groups to undergo either a procedure for prolapse and hemorrhoids (PPH) (n = 54) or conventional surgery (n = 54; control group). Short-term (operative time, postoperative hospital stay, postoperative urinary retention, postoperative perianal edema, and postoperative pain) and long-term (postoperative anal stenosis, postoperative sensory anal incontinence, postoperative recurrence, and postoperative difficulty in defecation) clinical effects were compared between the two groups. The short- and long-term efficacies of the two procedures were determined. RESULTS: In terms of short-term clinical effects, operative time and postoperative hospital stay were significantly shorter in the PPH group than in the control group (24.36 ± 5.16 min vs 44.27 ± 6.57 min, 2.1 ± 1.4 d vs 3.6 ± 2.3 d, both P < 0.01). The incidence of postoperative urinary retention was higher in the PPH group than in the control group, but the difference was not statistically significant (48.15% vs 37.04%). The incidence of perianal edema was significantly lower in the PPH group (11.11% vs 42.60%, P < 0.05). The visual analogue scale scores at 24 h after surgery, first defecation, and one week after surgery were significantly lower in the PPH group (2.9 ± 0.9 vs 8.3 ± 1.1, 2.0 ± 0.5 vs 6.5 ± 0.8, and 1.7 ± 0.5 vs 5.0 ± 0.7, respectively, all P < 0.01). With regard to long-term clinical effects, the incidence of anal stenosis was lower in the PPH group than in the control group, but the difference was not significant (1.85% vs 5.56%). The incidence of sensory anal incontinence was significantly lower in the PPH group (3.70% vs 12.96%, P < 0.05). The incidences of recurrent internal rectal prolapse and difficulty in defecation were lower in the PPH group than in the control group, but the differences were not significant (11.11% vs 16.67% and 12.96% vs 24.07%, respectively). CONCLUSION: PPH is superior to the traditional surgery in the management of outlet obstructive constipation caused by internal rectal prolapse with circumferential hemorrhoids. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/26185392/Procedure_for_prolapse_and_hemorrhoids_vs_traditional_surgery_for_outlet_obstructive_constipation_ L2 - https://www.wjgnet.com/1007-9327/full/v21/i26/8178.htm DB - PRIME DP - Unbound Medicine ER -