KẾT QUẢ PHẪU THUẬT MILLIGAN - MORGAN BẰNG DAO LIGASURE VÀ HARMONIC ĐIỀU TRỊ TRĨ HỖN HỢP

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Tác giả: Minh Thịnh Hà, Văn Nông Lại, Văn Lâm Nguyễn

Ngôn ngữ: Vie

Ký hiệu phân loại:

Thông tin xuất bản: Y Dược học Cần Thơ 2021

Mô tả vật lý: 185-190

Bộ sưu tập: Metadata

ID: 394818

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Bệnh trĩ là một trong những bệnh lý ngoại khoa phổ biến nhất. Phẫu thuật cắt trĩ vẫn là phương pháp triệt để điều trị trĩ hỗn hợp. Phẫu thuật Milligan - Morgan rất thường được chỉ định và được xem là phẫu thuật kinh điển điều trị bệnh trĩ. Với những tiến bộ của khoa học kỹ thuật trong thời gian gần đây, dao đốt điện lưỡng cực LigaSure và dao siêu âm Harmonic đã ra đời giúp giảm đau sau phẫu thuật cũng như giảm tỉ lệ chảy máu chu phẫu. Mục tiêu nghiên cứu: 1). Khảo sát đặc điểm lâm sàng, hình ảnh video của bệnh nhân trĩ hỗn hợp
2). Kết quả điều trị trĩ hỗn hợp bằng phẫu thuật Milligan - Morgan sử dụng dao Harmonic và dao LigaSure. Đối tượng và phương pháp nghiên cứu: Thử nghiệm lâm sàng ngẫu nghiên với 94 trường hợp trĩ hỗn hợp phẫu thuật Milligan - Morgan bằng LigaSure hoặc Harmonic tại Bệnh viện Trường Đại học Y Dược Cần Thơ từ tháng 7 năm 2020 đến tháng 7 năm 2021. Kết quả: Thu thập được 47 trường hợp được phẫu thuật bằng LigaSure (nhóm 1) và 47 trường hợp phẫu thuật bằng Harmonic (nhóm 2). Nhóm nghiên cứu có 52 bệnh nhân nam và 42 bệnh nhân nữ, độ tuổi trung bình là 44,30 ± 13,71 tuổi. Thời gian phẫu thuật trung bình là 40,74 ± 12,38 (phút). Đánh giá thang điểm đau hiển thị 24h sau mổ là 6,77 ± 1,74 (điểm). Lượng máu mất trong mổ của nhóm 1 ít hơn so với nhóm 2 [0,91 ± 0,35 (ml) so với 4,63 ± 0,95 (ml), p = 0,001]. Thời gian nằm viện, thời gian đi tiêu lần đầu tiên và mức độ hài lòng của người bệnh tương tự nhau giữa hai nhóm. Kết luận: LigaSure và Harmonic là các phương tiện an toàn và hiệu quả trong phẫu thuật điều trị trĩ hỗn hợp., Tóm tắt tiếng anh, Hemorrhoidal disease is the one of the most common problems in surgical practice. Hemorrhoidectomy remains the most definitive way to treat symptomatic mixed hemorrhoids. Milligan - Morgan procedure is commonly used and widely considered to be the most effective approach, very often called conventional hemorrhoidectomy. Thus a recent advance in developing sophisticated bipolar electrothermal device - LigaSure and Ultrasonic Harmonic Scalpel have provided effective alternatives, resulting in less postoperative pain as well as perioperative bleeding. Objectives: 1) To survey on clinical manifestations and video images of mixed hemorrhoids
2). To evaluate the results of Milligan - Morgan hemorrhoidectomy by using LigaSure and Harmonic. Materials and methods: Randomized clinical trials with 94 mixed hemorrhoids undergoing Milligan - Morgan hemorrhoidectomy at Can Tho University of Medicine and Pharmacy Hospital from July 2020 to July 2021. Results: Forty - seven patients treated with LigaSure (group 1) and forty - seven patients treated with Harmonic (group 2) were enrolled in the study. The study population included 52 males and 42 females, mean age of the patients was 44,30 ± 13,71 years. The mean length of the procedure was 40,74 ± 12,38 (min). The VAS score at 24 hours postoperatively was 6,77 ± 1,74. The median (range) intraoperative blood loss was significantly less in group 1 than in group 2 [0,91 ± 0,35 (ml) vs 4,63 ± 0,95 (ml), p = 0.001]. Theduration of the hospital stay, the time to first bowel motion, and patient satisfaction score were similar between the two groups. Conclusion: Milligan-Morgan hemorrhoidectomies by using Harmonic scalpel and LigaSure are safe and effective procedures for mixed hemorrhoidal disease

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