醫(yī)學(xué)外文翻譯--單中心分析應(yīng)用奧里根一次性套扎治療痔瘡（英文）

1、Banding ligation of hemorrhoidsJ Gastrointestin Liver Dis June 2007 Vol.16 No 2, 163-165 Address for correspondence: Moschos John MD, PhD Papadimitriou 10 Str. Kalamaria 55131, Greece E-mail: gut@in.grBanding Hemorrhoids

2、 Using the O’ Regan Disposable Bander. Single Center ExperienceDimitrios Paikos1, Anthie Gatopoulou1, John Moschos1, Anastasios Koulaouzidis2, Shivram Bhat2, Dimitrios Tzilves1, Konstantinos Soufleris1, Dimitrios Tragian

3、nidis1, Ioannis Katsos1, Anestis Tarpagos11) “Theagenio” Hospital, Thessaloniki, Greece. 2) Warrington General Hospital, Cheshire, UKAbstractBackground. Hemorrhoids are the most common anorectal disorder in the Western W

4、orld and are a major cause of active, relapsing or chronic rectal bleeding. Many treatment options have been proposed and tried for early- stage hemorrhoids. There is general agreement that rubber banding ligation (RBL)

5、is safe and effective. Aims. To evaluate the effectiveness and complications associated with RBL performed in outpatients for symptomatic hemorrhoids using the O’Regan Disposable Bander device. Results. Sixty consecutive

6、 patients underwent hemorrhoid banding with the O’Regan Disposable Bander.The mean time required for one session was 6.2 min; the longest was 10 min. No major complications were noted. Minor early and late bleeding was r

7、eported in 10% and 6.7% respectively, but none was severe. Pain occurred in 6.7% but was not severe. In all cases, clinical and endoscopic (range and form scores) improvement was observed and patients of all ages, includ

8、ing the elderly, were found to be tolerant to the procedure. Conclusion. RBL performed in outpatients for symptomatic hemorrhoids using the O’Regan Disposable Bander device is associated with a good response and low comp

9、lication rate. We recommend the technique as a safe and reliable treatment option.Key words Hemorrhoids - O’Reagan disposable bander - rubber banding ligationIntroductionHemorrhoids are the most common anorectal disorde

10、r in the Western World (1). Many treatment options have been proposed and tried. There is general agreement that rubber banding ligation (RBL) is safe and effective. Surgery shouldbe reserved for 3rd or 4th grade hemorrh

11、oids, “mixed” hemorrhoids not responding to RBL or patients on anticoagulants. The ideal treatment is easily learned, cost effective, gives satisfactory results and lacks complications. RBL is recommended as the initial

12、mode of therapy for hemorrhoids of grade 1 to 3. Our aim was to evaluate the effectiveness and complications associated with RBL performed in outpatients for symptomatic hemorrhoids using the O’ Regan Disposable Bander d

13、evice.Material and methodsBetween September 2005 and March 2006, 60 consecutive patients (32 men, 28 women) underwent RBL with the O’ Regan Disposable Bander. All patients had internal hemorrhoids of grade 1 to 4 (accord

14、ing to the Goligher grading system which is a four- stage grading for internal hemorrhoids) (2). All patients had undergone unsuccessful conservative treatment. The study design was approved by the hospital’s Ethics Comm

15、ittee. Written informed consent was obtained from each patient. Patients with associated anal fissures, anal spasm or infectious anal pathologies and patients who refused to sign the informed consent form were excluded f

16、rom the study. All patients were prepared for treatment by admi- nistration of a saline solution enema and application of a local anesthetic ointment (Xylocaine Gel 2%; Astra Zeneca, Webel, Germany) into the anal canal.

17、Early complications were defined as those occurring within a week. All RBLs were performed on an outpatient basis. The front end of the loaded ligator was initially inserted fully into the rectum and then slowly withdraw

18、n as it was angled acutely to point directly toward the site to be ligated, 1cm above the dentate line. The tissue was sucked into the ligator by withdrawing its plunger. A test for pain was performed by rotating the lig

19、ator through 180o while maintaining suction. If this maneuver caused discomfort the ligator was repositioned at a higher level. Suction was maintained for at least 30 seconds while the ligator was rotated through 180o se

20、veral times to allow an adequate bite of tissue to beBanding ligation of hemorrhoids 165suggests RBL for treatment for grade 2 hemorrhoids while reserving haemorrhoidectomy for grade 3 hemorrhoids or recurrences after RB

21、L (11). Another recent study reported that RBL can be used to treat all degrees of hemorrhoids with similar effectiveness (12). In our study, 3-month follow- up was satisfactory regarding all grades of hemorrhoids apart

22、from grade IV. In conclusion, RBL performed in outpatients for symptomatic hemorrhoids using the O’ Regan Disposable Bander device is associated with a good response and low complication rate. We recommend the technique

23、 as a safe and reliable treatment option.4. Fukuda A, Kayjiyama T, Arakawa H et al. Retroflexed endoscopicmultiple band ligation of symptomatic internal hemorrhoids.Gastrointest Endosc 2004;59:380-3845. Gupta PJ. Radiof

24、requency coagulation versus rubber band ligationin early hemorrhoids: pain versus gain. Medicina (Kaunas) 2004;40: 232-237.6. Cleator IG, Cleator MM Banding Hemorrhoids Using the O’Regan Disposable Bander. Business Brie

25、fing: US Gastroentero-logy Review 2005: 69-73.7. Gupta PJ. Infrared coagulation versus rubber band ligation inearly stage hemorrhoids. Braz J Med Res 2003; 36: 1433-1438.8. Pfenninger JL, Surrell J. Nonsurgical treatment

26、 options forinternal hemorrhoids. Am Fam Phycisian 1995: 52: 821-8349. MacRae HM, McLeod RS. Comparison of hemorrhoid treatment:a meta analysis. Can J Surg 1997; 40: 14-17.10. Schwartz SI. Principles of surgery, 6th Ed

27、., McGraw-Hill, N.York1994 , pp, 222-1.229.11. Shanmugam V, Thaha MA, Rabindranath KS, Campbell KL,Steele RJ, Loudon MA. Rubber band ligation versus excisionalhaemorrhoidectomy for hemorrhoids. Cochrane Database SystRev

28、2005;20: CD005034.12. Iyer VS, Shrier I, Gordon PH. Long-term outcome of rubberband ligation for symptomatic primary and recurrent internalhemorrhoids. Dis Colon Rectum 2004; 47: 1364-1370.References1. Leff E. Hemorrhoid

29、s. Postgrad Medicine 1987; 82: 95-101.2. Su MY, Chiu CT, Wu CS, et al. Endoscopic hemorrhoidal ligationof symptomatic internal hemorrhoids. Gastrointest Endosc2003; 58: 871-874.3. O’ Regan PJ. Disposable device and a min