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Do We Need Fluid Restriction after Stapled Hemorrhoidopexy? A Pilot, Double-blinded, Randomized Controlled Trial

痔瘡環切術後需要限水嗎?一項前驅、雙盲、隨機對照試驗

摘要


Background. Conventional hemorrhoidectomy leads to a high urinary retention rate and fluid restriction is commonly recommended to minimize complications. However, the need for postoperative fluid restriction among patients who have undergone stapled hemorrhoidopexy is unclear. We aimed to determine whether fluid restriction after stapled hemorrhoidopexy with/without partial external hemorrhoidectomy could reduce urinary retention and postoperative pain. Patients and Methods. In this prospective, double-blinded, randomized controlled trial, we enrolled patients who had grade III or IV hemorrhoids and underwent stapled hemorrhoidopexy with/without partial external hemorrhoidectomy; 250 mL/12 h of sterile 0.9% saline was administered to the fluid restriction group after the operation, and 1000 mL/12 h was given to the non-fluid-restriction group. We focused on the need for fluid restriction after stapled hemorrhoidopexy. Results. Fifty patients were divided into two groups. The surgical outcomes were of no difference between the two groups. The median subjective pain scores at 0, 8, 16, 24 h after the operation showed no significant difference between the two groups (p = 0.55 at 0 h; p = 0.38 at 8 h; p = 0.98 at 16 h; and p = 0.66 at 24 h). The mean times to first urination after the operation were 700.04 ± 455.03 mins in the non-fluid-restriction group and 737.16 ± 426.32 mins in the fluid-restriction group (no significant difference; p = 0.67). No postoperative urinary retention was found in either group of patients. Conclusions. Fluid restriction after stapled hemorrhoidopexy is unnecessary.

並列摘要


常規痔瘡切除術易導致術後尿滯留,因此術後常需要限制水分攝取以降低併發症發生。然而,痔瘡環切術術後是否需要限水仍未有定論。為此我們設計了一個雙盲、隨機對照試驗,將55位三、四級痔瘡病人分為兩組,在接受痔瘡環切術後12小時內,一組只能攝取250 ml,而另一組給予1000 ml點滴,比較術後尿滯留及疼痛的比例。研究結果發現,術後無論是否有水份攝取限制,疼痛分數及術後尿滯留發生比率均無顯著差異。

並列關鍵字

痔瘡環切術 術後尿滯留 術後疼痛 限水

參考文獻


Ratto C, Campennì P, Papeo F, Donisi L, Litta F, Parello A. Transanal hemorrhoidal dearterialization (THD) for hemorrhoidal disease: a single-center study on 1000 consecutive cases and a review of the literature. Techniques in coloproctology 2017; 21(12): 953-62.
Riss S, Weiser FA, Schwameis K, et al. The prevalence of hemorrhoids in adults. International journal of colorectal disease 2012; 27(2): 215-20.
Geller EJ. Prevention and management of postoperative urinary retention after urogynecologic surgery. International journal of women's health 2014; 6: 829.
Prasad ML, Abcarian H. Urinary retention following operations for benign anorectal diseases. Diseases of the Colon & Rectum 1978; 21(7): 490-2.
Agrawal K, Majhi S, Garg R. Post-operative urinary retention: Review of literature. World Journal of Anesthesiology 2019; 8(1): 1-12.

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