치핵 치료에 관한 연구 (2) 고무 밴드 요법

Abstract

Treatment of hemorrhoid dates back to the Baby- Ionian era. Over the years, numerous modifications and techniques have been employed to improve the results and decrease the morbidity of operatibe hemorrhoidectomy. In recent years, alternatives have been introduced in an effort to reduce the morbidity associated with surgical hemorrhoidectomy. Rubber ring ligation has become one of the most popular of these alternative procedures. The concept of ligation of hemorrhoidal tissue was revived by Blaisdell and modified by Barron in 1963. Initial studies emphasized the simplicity, safety. The indication for Rubber Ring Ligation may be listed as follows. 0) For all cases of first and second degree redundant internal hemorrhoid. (2) Second degree and a part of third degree hemorrhoids with moderate, self-reducing prolapse respond best to this mode of treatment. We collected 34 cases, which had been done at a.p.D. as Rubber Ring Ligation method during L. 5 year from July, 1980 to December, 1981 in St. Mark's Hospital in London and Seoul National University Hospital. The results were as follows. (1) The indications for Rubber Ring Ligation were bleeding(82.4%), prolapse (88. 2:'6), pain (2G.6"6), pruritis (5.9:'6) and discharge (2.9°6). (2) Classification of preoperative symptom were as follows. (a) 55.9% (19 cases) was bleeding. (b) 41. 2:'6 (14 cases) was self reduction protrusian. (c) 2.9% (I case) was prolapse requiring manual reduction. (3) Number of hemorrhoids ligated were as foll- OW5. (a) 55.9% (19 cases) was I. (h) 35.3% (12 cases) was 2. (c) 8.8% (3 cases) was 3. (4) After Rubber Ring Ligation were as follows. (a) ,,5.9% (19 cases) was no symptoms. (h) 23. 5?~ (8 cases) was greatly improved. (c) II. 8% (4 cases) was mild improved. (d) 5.9% (2 cases) was unchanged. (e) 2.9% (I case) was worse. (5) The sex ratio (male to female) was 2: I approximately. A good results of male was 81. 8ea (18 cases) and a good results of female was 75.0% (9 cases).