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배출곤란을 동반한 치핵환자에서 치핵절제술 후 증상과 내압의 변화

Changes of Symptoms and Manometric Results after Hemorrhoidectomy for Hemorrhoids with Difficulty in Evacuation

대한대장항문학회지 2006년 22권 4호 p.235 ~ 240
박혜원 ( Park Hye-Won ) - 을지대학교 의과대학 외과학교실

방승호 ( Bang Seung-Ho ) - 대전보훈병원
김창남 ( Kim Chang-Nam ) - 을지대학교 의과대학 외과학교실
강윤중 ( Kang Yoon-Jung ) - 을지대학교 의과대학 외과학교실
황성은 ( Hwang Sung-Eun ) - 서울대학교 의과대학 외과학교실
조병선 ( Joe Byung-Sun ) - 을지대학교 의과대학 외과학교실
이민구 ( Lee Min-Koo ) - 을지대학교 의과대학 외과학교실
최유신 ( Choi Yoo-Shin ) - 을지대학교 의과대학 외과학교실
박주승 ( Park Joo-Seung ) - 을지대학교 의과대학 외과학교실
김진천 ( Kim Jin-Cheon ) - 울산대학교 의과대학 서울아산병원 외과학교실

Abstract


Purpose: We aimed to identify the need for an adjunctive internal sphincterotomy based on an evaluation of the changes in the symptoms and manometric results after a hemorrhoidectomy for hemorrhoids with difficulty in evacuation.

Methods: Twenty-five (25) patients who had hemorrhoids with difficulty in evacuation and 13 patients who had hemorrhoids without difficulty in evacuation were prospectively evaluated. Patients were interviewed about symptoms and underwent anorectal manometry before and 2 months after surgery. Difficulty in evacuation is defined as the difficulty that a patient has when trying to evacuate the rectum.

Results: There were significant differences in the sex ratio, the frequency of bowel movements, and the duration of bowel movements between the two groups (P<0.05). In cases with difficulty in evacuation, the frequency of bowel movements was significantly higher postoperatively and the duration of bowel movements was significantly shorter (P<0.05). The symptom of difficulty in evacuation disappeared in 21 of the as patients experiencing such a symptom, and was improved in the remaining of patients (P<0.05). Following the hemorrhoidectomy for the patients with difficulty in evacuation in the mean and the maximum resting pressure, and the maximum squeeze pressure decreased significantly (P<0.05).

Conclusions: An adjunctive internal sphincterotomy was not necessary for patients who had hemorrhoids with difficulty in evacuation because following the hemorrhoidectomy, the resting pressure was significantly decreased, and the difficulty in evacuation had nearly subsided. J Korean Soc Coloproctol 2006;22:235-240

키워드

증상;내압;치핵절제술;치핵;배출곤란
Symptom;Manometric result;Hemorrhoidectomy;Hemorrhoids;Difficulty in evacuation
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