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개방형 치핵절제술

Open Hemorrhoidectomy

대한대장항문학회지 2007년 23권 4호 p.279 ~ 285
김도선 ( Kim Do-Sun ) - 대항병원 외과

Abstract


The open hemorrhoidectomy has been recognized as the treatment of choice for symptomatic prolapsing hemorrhoids. Although the open hemorrhoidectomy is thought to be associated with more postoperative pain and delayed wound healing compared with other conventional procedures such as a closed hemorrhoidectomy, and a semi- closed or submucosal hemorrhoidectomy, it is still unclear which procedure is preferable in terms of postoperative pain, wound healing, hospital stay, and time off work. To address this issue, several studies have been performed. According to randomized controlled studies comparing an open hemorrhoidectomy to a closed hemorrhoidectomy, there are no significant differences in the severity of pain and the hospital stay between the two procedures; however, the healing time in the closed hemorrhoidectomy is faster and the operation time in the open hemorrhoidectomy is shorter. Since there are few randomized controlled studies comparing an open hemorrhoidectomy with a semi-closed hemorrhoidectomy or submucosal hemorrhoidectomy, it is difficult to conclude which procedure is superior to the others. Yet, there seems to be no significant difference between these procedures. In 1998, a novel procedure, a stapled hemorrhoidopexy, was introduced by Longo. Several randomized controlled studies comparing the open hemorrhoidectomy with the stapled hemorrhoidopexy showed that the latter was associated with less pain, shorter hospital stay, and earlier return to work. However, considering the lack of long- term data and the disastrous complications, such as retroperitoneal sepsis and rectal perforation, there is still controversy about its efficacy and safety as a definitive treatment of hemorrhoids. The open hemorrhoidectomy is time-tested and is comparable to other conventional techniques in terms of postoperative pain, hospital stay, and time off work. Further study should be performed to assess the long-term results of a stapled hemorrhoidopexy. J Korean Soc Coloproctol 2007;23:279-285

키워드

개방형 치핵절제술;폐쇄형 치핵절제술;반폐쇄형 치핵절제술;점막하 치핵절제술;원형문합기를 이용한 치핵고정술
Open hemorrhoidectomy;Closed hemorrhoidectomy;Semi-closed hemorrhoidectomy;Submucosal hemorrhoidectomy;PPH
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