Yong-Heng He1, Zhi-Jun Tang2, Xiang-Tong Xu3, De-Quan Huang4, Li-Shun Zhang5, Qing-Zhu Tang6, Zhi-Min Fan7, Xian-Jun Zou8, Guo-Jun Zou9, Chong-Yang Zhang10, Fan Hu1, Biao Xie1, Yan-Hua Li2, Yao Tong3, Hong-Chang Liu4, Ke Li5, Yu-Lian Luo6, Fei Liu7, Guang-Wei Situ8, Zuo-Long Liu9. 1. 1 The Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha, Hunan, China. 2. 2 Changde Hospital of Hunan University of Traditional Chinese Medicine, Hunan, China. 3. 3 Xuzhou Hospital of Nanjing University of Traditional Chinese Medicine, Jiangsu, China. 4. 4 Teaching Hospital of Chengdu University of Traditional Chinese Medicine, Hunan, China. 5. 5 Changsha Hospital of Hunan University of Traditional Chinese Medicine, Hunan, China. 6. 6 Chenzhou Hospital of Southern Medical University, Hunan, China. 7. 7 The Third Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Jiangsu, China. 8. 8 Eighth Hospital of Wuhan City, Hubei, China. 9. 9 Yueyang Hospital of Hunan University of Traditional Chinese Medicine, Hunan, China. 10. 10 Hebei Province Cangzhou Hospital of Integrated Traditional and Western Medicine, China.
Abstract
PURPOSE: To explore the safety and efficacy of Ruiyun procedure for hemorrhoids (RPH) or RPH with the simplified Milligan-Morgan hemorrhoidectomy (sMMH) in the treatment of mixed hemorrhoids. METHODS: This is a randomized, controlled, balanced, multicenter study of 3000 patients with mixed hemorrhoids. The outcomes and postoperative complications were compared between 5 types of surgeries. RESULTS: The efficacy rate was the highest in patients who received RPH+sMMH and decreased in the following order: patients who received RPH alone, MMH alone, procedure for prolapse and hemorrhoids (PPH) alone, and PPH+sMMH ( P < .05). The operation time was the shortest in patients who received RPH alone and increased in the following order: patients who received RPH+sMMH, PPH alone, MMH alone, and PPH+sMMH ( P < .01). The duration of postoperative hospitalization stay was the shortest in patients who received RPH alone and increased in the following order: PPH alone, RPH+sMMH, PPH+sMMH, and MMH alone ( P < .01). The incidence of postoperative hemorrhage, uroschesis, anal fissure, crissum hematoma or thrombosis, and anorectal stenosis was significantly lower in patients who received RPH+sMMH than in patients who received the other 4 types of surgical treatments ( P < .05, P < .01). No significant differences in postoperative rectovaginal fistula and anal incontinence were observed between the 5 groups of patients. CONCLUSIONS:RPH with or without simplified MMH can reduce the incidence of postoperative complications and improve the curative efficacy in the treatment of patients with mixed hemorrhoids.
RCT Entities:
PURPOSE: To explore the safety and efficacy of Ruiyun procedure for hemorrhoids (RPH) or RPH with the simplified Milligan-Morgan hemorrhoidectomy (sMMH) in the treatment of mixed hemorrhoids. METHODS: This is a randomized, controlled, balanced, multicenter study of 3000 patients with mixed hemorrhoids. The outcomes and postoperative complications were compared between 5 types of surgeries. RESULTS: The efficacy rate was the highest in patients who received RPH+sMMH and decreased in the following order: patients who received RPH alone, MMH alone, procedure for prolapse and hemorrhoids (PPH) alone, and PPH+sMMH ( P < .05). The operation time was the shortest in patients who received RPH alone and increased in the following order: patients who received RPH+sMMH, PPH alone, MMH alone, and PPH+sMMH ( P < .01). The duration of postoperative hospitalization stay was the shortest in patients who received RPH alone and increased in the following order: PPH alone, RPH+sMMH, PPH+sMMH, and MMH alone ( P < .01). The incidence of postoperative hemorrhage, uroschesis, anal fissure, crissum hematoma or thrombosis, and anorectal stenosis was significantly lower in patients who received RPH+sMMH than in patients who received the other 4 types of surgical treatments ( P < .05, P < .01). No significant differences in postoperative rectovaginal fistula and anal incontinence were observed between the 5 groups of patients. CONCLUSIONS: RPH with or without simplified MMH can reduce the incidence of postoperative complications and improve the curative efficacy in the treatment of patients with mixed hemorrhoids.
Authors: Q Z Ruan; W English; A Hotouras; C Bryant; F Taylor; S Andreani; S D Wexner; S Banerjee Journal: Tech Coloproctol Date: 2020-10-24 Impact factor: 3.781