Ruiz Castro V, Vargas AW

Language: Spanish
References: 8
Page: 70-75
PDF size: 353.20 Kb.

ABSTRACT

Purpose: The aim of this study was to evaluate the simplicity of PPH procedure in the surgical treatment of complicated hemorrhoids G-III-IV, postoperative pain and itself complications. Material and methods: That work was a prospective study made since february 2002 to december 2005 of a major ambulatory surgery program, with 50 (100%) patients, 34 (68%) male and 16 (32%) female, the mean age was 40 years between (20-75 years). Each one with diagnosis of combined hemorrhoids G-III-IV, with symptom of protrusion and prolapse, the position was litothomy, the technique was made with local anesthesia and sedation (diprivan, fentanyl and midazolan) I.V. and pudendal nerve was blocked with lidocaine 2%. The apport of the technique is make the hem with Dermalon 00, to 2 cm up of the dentate line, starting at 9 o’clock and finishing at 3 o‘clock, it means from right to left and another suture but inverse or opposite direction. It means from 3 to 9. Leting this modification a more simetric traction of the hem and them make the shoot of stapling, as is evidence to send the resected tissue circumference to pathology. Results: There were 7 (14%) patients with complications, 2 (4.5%) patients had severe pain in the postoperatory 48 h that sumit with Ketorolaco I.M. 2 (4.5%) with acute urine retention resolved with catheterization, 1 (2.3%) patient with acute hemorrhage resolved with stitch the bleeding vessel with Vicryl 3 zeros. 1 (2.3%) patient had an external thrombotic hemorrhoid, madding thrombectomy and ligation of it. 1 (2.3%) patient had an anal stenosis after a mounth, this one was reoperate madding plasty and closure of the mucosal without problem. Rest of the patients 43 (86%) with excellent evolution. Discussion: Surgery for hemorrhoidal disease till now is a controversy question for it immediatly complications an so the techniques or procedures to gain minimize the pain as main symptom of classic techniques as Milligan-Morgan and Ferguson, they will give so much to the postoperative prognostic, furthermore there are different randomized and controlled works, that mentions this where Longo technique gives little or not complain in postoperative and also making that patient incorporate to normal activities quickly.

REFERENCES

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