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Inter.st of Scler.sing Injections in Hemor.hoidal Pathology: Exper.ence of the Ser.ice of Hepato-Gastr.enter.logy of Fez

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Open Jour.al of Gastr.enter.logy 2019年第1期9卷 36-42页

作者： H. Abid r. benjira M. Lahlali A. Lamine N. Lahmidani M. Elyousfi N. Aqodad D. Benajah A. Ibr.himi M. Elabkar. Hepato-Gastr.enter.logy Depar.ment Hassan II University Medical Center Fez Morocco Faculty of Medicine Sidi Mohammed Ben Abdellah University Fez Morocco

Hemor.hoids ar. a clinical and anatomical subject that has not been completely investigated [1]. This benign condition is expr.ssed by inter.ittent functional manifestations as r.ctor.hagies and pr.lapse. while the medical tr.atments seek to r.lieve symptoms, the instr.mental ones ar. intended to r.position and hold the hemor.hoids in an anatomically cor.ect position and to r.duce their.vascular.ty [1]. Indeed, scler.ther.py seems an effective and safe method in fact. Aim of the Study: To r.por. the r.sults of a mor.ccan ser.es of patients tr.ated with scler.sing injections, emphasizing shor.- and long-ter. efficacy as well as the r.te of complications. Methods: This is a descr.ptive r.tr.spective study of the 148 patients with symptomatic inter.al hemor.hoids who have been tr.ated with scler.ther.py in the gastr.enter.logy depar.ment of the univer.ity medical center.of Fez over.a per.od of 17 year. [2001-2018]. r.sults: The aver.ge age of our.patients is 47.1 year. [19 - 86]. We notified a lar.e male pr.dominance with a sex r.tio M/F 2.58. r.ctor.hagies and pr.lapse wer. the most fr.quent r.asons for.consultation;they wer. r.spectively notified in 96% (n = 143) and 83% of patients (n = 123). Anemia was found in 45 cases (30.4%), of which 29 cases r.quir.d tr.nsfusion. Pr.ctologic examination found inter.al hemor.hoids gr.de 2 in 83% (n = 124) and gr.de 1 in 16.2% (n = 24) of patients. Initial success was found in 119 cases (80.4%) after.an aver.ge of 2.25 sessions (1 - 4). Nine patients (8, 11%) had minor.complications dominated by minimal r.ctor.hagies in 8 cases, r.solved spontaneously. In 29 cases (19.5%), the sessions wer. inter.upted following a failur. of the technique in 12 cases (41.3%), in 11 cases after.change of the stage of hemor.hoids of stage II to III, in 4 cases following the appear.nce of an anal fissur. contr.indicating the pr.cedur., and in 2 cases due to sever. pain post scler.sis. Among these 29 cases, 13 patients wer. r.fer.ed for.sur.er., whi

关键词： Inter.al Hemor.hoids Scler.sing Injection Evolution Complications

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The Elastic Ligation of Inter.al Hemor.hoids: Wher. Ar. We Now?

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Open Jour.al of Gastr.enter.logy 2019年第1期9卷 28-35页

作者： H. Abid G. Ousseur.r. benjira M. Lahlali A. Lamine N. Lahmidani M. El Yousfi N. Aqodad D. Benajah A. Ibr.himi M. El Abkar. Hepato-Gastr.enter.logy Depar.ment Hassan II University Medical Center Fez Morocco Faculty of Medicine Sidi Mohammed Ben Abdellah University Fez Morocco

Hemor.hoidal disease r.quir.s differ.nt means of tr.atment: medical, sur.ical and instr.mental. Among these, the elastic ligatur. seems to be an effective and widespr.ad technique in the wor.d. The aim of our.study is to r.por. our.exper.ence in methodology and shor. and medium ter. r.sults of ligation in a population that str.ngly fear. sur.er.. Patients and Methods: It’s about a r.tr.spective and descr.ptive study of 208 outpatients tr.ated with elastic ligations for.symptomatic inter.al hemor.hoids. These patients wer. collected over.a per.od of 15 year. (October.2003-Apr.l 2018) at the gastr.enter.logy depar.ment of Hassan II CHU in Fez. r.sults: The aver.ge age of our.patients was 50.3 year. [20 - 82 year.] with a sex-r.tio M/F of 2.85. The clinical signs wer. dominated by r.ctor.hagia (99%) complicated by anemia in 116 cases r.quir.ng blood tr.nsfusion in 72 cases, followed by pr.ctalgia (27.4%). Tr.nsit disor.er. wer. noted in 65 patients (31.2%). Indications for.elastic ligation wer. symptomatic inter.al hemor.hoids Gr.de 3 (65.4%) and Gr.de 2 (34.6%). The aver.ge number.of ligation sessions that achieved the ther.peutic goal was 2.30 sessions [1 - 4]. The aver.ge number.of r.ngs per.session was 3.1 r.ngs [1 - 6]. Moder.te to sever. pain was r.por.ed by 20 patients (9.6%) mostly within 6 hour. of ligation. Minimal r.ctor.hagia was r.por.ed in 33 cases (15.8%). Ther. wer. no major.complications who r.quir.d a hospitalization. The success r.te was 80.7% (n = 168). Sur.er. was per.or.ed in 31 patients (14.9%) and scler.sis in 7 patients (3.3%). Conclusion: The elastic ligation of inter.al hemor.hoids r.mains an effective and inexpensive technique when it comes to the tr.atment of symptomatic inter.al hemor.hoids of Gr.de 2 to 3. The r.sults obtained in our.study wer. ver. r.assur.ng and motivating.

关键词： Inter.al Hemor.hoids Elastic Ligatur. Evolution

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