Orhan BAT, Cengiz ERİŞ, Bülent SULTANOĞLU, Yalim UÇTUM, Riza KUTANİŞ, Bülent KAYA

Stapler Hemoroidektomi Tekniğinin Erken Ve Geç Dönem Sonuçları

Amaç: Stapler hemoroidektomi hemoroid tedavisinde alternatif bir yöntemdir. Bu çalışmadastapler hemoroidektomi tekniğinin erken ve geç dönem sonuçlarını inceledik.Yöntem ve Gereç: Ocak 2000 ile Aralık 2009 tarihleri arasında Vakıf Gureba Eğitim veAraştırma Hastanesinde 44 hastaya (33 erkek 11 kadın) 3 ve 4. derece hemoroid nedeni staplerhemoroidektomi uygulandı. Ortalama yaş 43 (25-72 arası) idi. Preoperatif ve postoperatifsemptomlar, operasyon bilgileri, erken ve geç dönem komplikasyonlar, hastane yatış süresi vehasta memnuniyet skorları değerlendirildi. Kayıt edilen bilgiler SSPS 13 for Windows programıile değerlendirildi.Bulgular: Hemoroidlerin 30’u (%68.1) 3. evre 14’ü (%31.9) 4. evre idi. En sık preoperatifsemptom [n=39 (%88.6)] rektal kanama olarak bulundu. Diğer semptomlar; perianal şişlik[n=11(%25)], ağrı [n=10 (%22.7)] ve kaşıntı [n=2 (%4.5) ] idi. Altı hasta kronik anemi bulgularıile opere edildi.Ameliyat süresi 15 ile 75 dakika arasında değişmekteydi (ortalama; 26 dakika).Perioperatif komplikasyon görülmedi. Otuz hastada (% 68.1) mukozal kanama nedeni ilehemostatik sütur uygulandı. Ondört hastada postoperatif problemler görüldü. En sık postoperatifproblem 8 hastada tespit edilen idrar retansiyonuydu.Sonuç: Stapler hemoroidektomi düşük komplikasyon oranları ile etkin ve güvenilir bir cerrahiyöntemdir. Günübirlik cerrahi olarak uygulanabilir. Staplerin ateşlenmesi sonrası mukozalkanama varlığında hemostatik sutür uygulanması önerilir

Anahtar Kelimeler:

Stapler hemoroidektomi, komplikasyonlar, günübirlik cerrahi

Short And Long Term Results Of Stapled Hemorrhoidectomy

Purpose: Stapled hemorrhoidectomy is an alternative surgical technique in hemorrhoidtreatment. We studied the early and long term results of stapled hemorrhoidectomy.Material and Methods: Between January 2000 and December 2009, 44 patients (33 men and11 women) with an avarage age of 43 years (range 25 to 72) underwent stapledhemorrhoidectomy for third or fourth degree hemorrhoids in Vakif Gureba Training Hospital.Data about pre and postoperative symptoms, operation details, early and late term complications,length of hospital stay and patient satisfaction scores were collected. Statistical data is evaluatedwith SSPS 13 for windows.Results: Hemorrhoids were third degree in 30 patients (68.1%) and fourth degree in 14 patients(31.9%). Rectal bleeding was the most common preoperative symptom [n=39 (88.6%)]. Theother symptoms were perianal swelling [n=11 ( 25%)], pain [n=10 (22.7%)] and itching [n=2(4.5%)]. Six patients were operated with findings of chronic anemia. Operation time was rangedbetween 15 to 75 minutes (avarage 26 minutes). There were no perioperative complication.Haemostatic sutures for mucosal bleeding were needed in 30 cases (68.1 %). Postoperativeproblems were observed in 14 patients. The most common problem was urinary retention whichhas been detected in 8 patients.Conclusion: Stapled hemorrhoidectomy is safe, effective surgical technique with lowcomplication rates. It can be performed in ambulatory setting. The haemostatic suturing afterfiring of stapler is needed and advised

Keywords:

Stapled hemorrhoidectomy, complications, ambulatory surgery,

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