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| 번호 | 제목 | 등록일 | 조회수 |
|---|---|---|---|
| 80 | Internal Sphincterotomy With Hemorrhoidectomy Does Not Relieve Pain [2002년 11월 DCR] | 2011-11-17 | 3401 |
|
A Prospective, Randomized Study
Indru T. Khubchandani, M.D.
From the College of Medicine, Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, Pennsylvania, and Department of Surgery, Division of Colon and Rectal Surgery, Lehigh Valley Hospital, Allentown, Pennsylvania
PURPOSE: Pain after hemorrhoidectomy is universal. Several attempts have been made to reduce or alleviate the pain after excisional hemorrhoidectomy. The origin of pain is undetermined. Current theories propose that the pain is mediated through the internal sphincter. This prospective, randomized study was performed to assess the degree of discomfort in patients with and without a sphincterotomy
when performing a closed hemorrhoidectomy. METHODS: Between December 1999 and September 2001, 42 patients (22 males), median age 52 (range, 30–80) years, who underwent excisional hemorrhoidectomy were randomly chosen to have an internal sphincterotomy in the base of the left lateral wound.
RESULTS: Thirty-nine patients were available for the study. Parameters elicited in the study were
pain, postoperative bleeding, urinary retention, impairment of continence by day and by night, and day the patient returned to work. There was no statistical difference in the postoperative pain in each of the two categories at four hours after surgery, after the first bowel movement, or four days after surgery. CONCLUSIONS: Results showed no difference in the perception of pain after hemorrhoidectomy
in patients who had an internal sphincterotomy compared with those who did not. Both groups were equally likely to have difficulty with control of gas and soiling. |
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