Erken evre hemoroid tedavisinde infrared koagulasyon ve lastik bant ligasyon

GÜLİTER, Sefa; ÖZKURT, Zübeyde; EBİNÇ, Fatma; KELEŞ, HATİCE; YAKARYILMAZ, Fahri

Erken evre hemoroid tedavisinde infrared koagulasyon ve lastik bant ligasyon

Fahri YAKARYILMAZ, (Kırıkkale Üniversitesi, Tıp Fakültesi, Gastroenteroloji Anabilim Dalı, Kırıkkale, Türkiye)

Sefa GÜLİTER, (Kırıkkale Üniversitesi, Tıp Fakültesi, Gastroenteroloji Anabilim Dalı, Kırıkkale, Türkiye)

Zübeyde ÖZKURT, (Kırıkkale Üniversitesi, Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Kırıkkale, Türkiye)

Hatice KELEŞ, (Kırıkkale Üniversitesi, Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Kırıkkale, Türkiye)

Fatma EBİNÇ (Kırıkkale Üniversitesi, Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Kırıkkale, Türkiye)

Akademik Gastroenteroloji Dergisi

21 0

Yıl: 2006 Cilt: 5 Sayı: 3 Sayfa Aralığı: 179 - 183 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Erken evre hemoroid tedavisinde infrared koagulasyon ve lastik bant ligasyon

Öz:

Giriş ve amaç: Semptomatik hemoroidlerin tedavisi için cerrahi dışı farklı yöntemler olmasına rağmen bunların hangisinin daha üstün olduğu tartışmalıdır. Bu çalışmada erken evre hemoroidlerin tedavisinde lastik bant ligasyon (LBL) ve infrared koagulasyon (IRK)’un etkinliğinin ve komplikasyonlarının araştırılması amaçlandı. Gereç ve yöntem: Randomize prospektif bu çalışmada fleksible sigmoidoskopi ve anoskopik inceleme ile 2. derece internal hemoroid tanısı konulan, daha önce tedavi edilmemiş 51’i kadın, 40’ı erkek, median yaşı 42 (21–64) yıl olan 91 hastaya semptomlar kaybolana kadar 4 hafta ara ile bir veya daha fazla seansta LBL (n=45) veya IRK (n=46) uygulandı. Her seanstan bir hafta sonra ve son seanstan 2, 12 ve 24 ay sonra tedavilerin etkinliği ve komplikasyonları değerlendirildi. Ağrı değerlendirmesi 0 ile 10 arasında skorlanan vizüel analog skala (VAS) ile yapıldı. Bulgular: LBL ve İRK gruplarında ortalama tedavi seans sayısı benzerdi (1.73±0.45 ve 1.78±0.42, p>0.05). Postoperatif birinci hafta sonunda spontan ağrı için ortalama VAS skorları LBL ve IRK gruplarında sırası ile 3.8±2.1 ve 2.4±2.0 idi (p<0.05). LBL grubunda VAS skoru >5 olan hasta sayısı 5 iken, IRK grubunda 0 idi (p<0.05). Birinci hafta sonunda rektal tenezm sıklığı LBL grubunda %26.6, IRK grubunda %6.5 bulundu (p<0.01). Sekizinci hafta sonunda iki grupta da hiçbir hastanın rektal ağrı ve/veya tenezm yakınması yoktu. LBL ve IRK’nın rektal kanamayı önlemedeki başarısı sırası ile 2. ayda %97.8 ve %89.1 (p>0.05), 12. ayda %88.9 ve %82.6 (p>0.05), ve 24. ayda %86.7 ve %54.3 (p<0.01) idi. Sonuç: LBL ikinci derece hemoroidlerin kanama kontrolünde IRK’dan daha etkilidir. Ancak postoperatif erken komplikasyonlar LBL’de daha sıktır. Postopreratif 2. yıl nüks IRK’da daha sık olmasına rağmen komplikasyonların azlığı nedeni ile erken evre hemoroidlerin tedavisinde IRK ilk basamak tedavi seçeneği olabilir.

Anahtar Kelime: Komplikasyonlar İleriye dönük çalışma Bağlama Ağrı ölçümü Hemoroidler

Konular: Tıbbi Araştırmalar Deneysel Hematoloji Onkoloji Ortopedi

Infrared coagulation and rubber band ligation in the treatment of early stage hemorrhoids

Öz:

Background/aim: Although there are different non-surgical methods for the treatment of symptomatic hemorrhoids, which method is superior remains controversial. The aim of this study was to investigate the effectiveness and complications of rubber band ligation (RBL) and infrared coagulation (IRC) in the treatment of early stage hemorrhoids. Materials and methods: In this randomized prospective study, previously untreated 91 patients (51 female, 40 male; median age 42 (21-64) yrs) with second degree internal hemorrhoids diagnosed by flexible sigmoidoscopy and anoscopic examination underwent either RBL (n=45) or IRC (n=46) in two sessions with a four-week interval. Effectiveness, adverse effects and complications of each treatment method were evaluated at the end of the first week after each treatment session and at the 2nd, 12th and 24th months after the last session. Pain was evaluated with visual analogue scale (VAS) scored between 0-10. Results: The average treatment sessions were similar in both groups (RBL 1.73±0.45, IRC 1.78±0.42, p>0.05). The mean VAS scores for spontaneous pain at the end of the first week in the RBL and IRC groups were 3.8±2.1 and 2.4±2.0, respectively (p<0.05). The number of patients with VAS score of more than 5 in the two groups were 5 and 0 (p<0.05). While the occurrence of rectal tenesmus after one week of treatment was 26.6% in the RBL group, this ratio was 6.5% in the IRC group (p<0.01). No patient in either group had rectal pain and/or tenesmus at the end of the eighth week. The success of RBL and IRC in prevention of rectal bleeding was 97.8% and 89.1% (p>0.05) at the 2nd month, 88.9% and 82.6% (p>0.05) at the 12th month, and 86.7% and 54.3% (p<0.01) at the 24th month. Conclusion: RBL is more effective than IRC in the prevention of bleeding in second degree hemorrhoids. However, postoperative early complications are more frequent with RBL than with IRC. Although postoperative second year recurrence rate is more frequent in patients treated with IRC, it may be the first choice in the treatment of early stage hemorrhoids due to the rarity of complications.

Anahtar Kelime: Ligation Pain Measurement Hemorrhoids Complications Prospective Studies

Konular: Tıbbi Araştırmalar Deneysel Hematoloji Onkoloji Ortopedi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	YAKARYILMAZ F, GÜLİTER S, ÖZKURT Z, KELEŞ H, EBİNÇ F (2006). Erken evre hemoroid tedavisinde infrared koagulasyon ve lastik bant ligasyon. , 179 - 183.
Chicago	YAKARYILMAZ Fahri,GÜLİTER Sefa,ÖZKURT Zübeyde,KELEŞ HATİCE,EBİNÇ Fatma Erken evre hemoroid tedavisinde infrared koagulasyon ve lastik bant ligasyon. (2006): 179 - 183.
MLA	YAKARYILMAZ Fahri,GÜLİTER Sefa,ÖZKURT Zübeyde,KELEŞ HATİCE,EBİNÇ Fatma Erken evre hemoroid tedavisinde infrared koagulasyon ve lastik bant ligasyon. , 2006, ss.179 - 183.
AMA	YAKARYILMAZ F,GÜLİTER S,ÖZKURT Z,KELEŞ H,EBİNÇ F Erken evre hemoroid tedavisinde infrared koagulasyon ve lastik bant ligasyon. . 2006; 179 - 183.
Vancouver	YAKARYILMAZ F,GÜLİTER S,ÖZKURT Z,KELEŞ H,EBİNÇ F Erken evre hemoroid tedavisinde infrared koagulasyon ve lastik bant ligasyon. . 2006; 179 - 183.
IEEE	YAKARYILMAZ F,GÜLİTER S,ÖZKURT Z,KELEŞ H,EBİNÇ F "Erken evre hemoroid tedavisinde infrared koagulasyon ve lastik bant ligasyon." , ss.179 - 183, 2006.
ISNAD	YAKARYILMAZ, Fahri vd. "Erken evre hemoroid tedavisinde infrared koagulasyon ve lastik bant ligasyon". (2006), 179-183.

APA	YAKARYILMAZ F, GÜLİTER S, ÖZKURT Z, KELEŞ H, EBİNÇ F (2006). Erken evre hemoroid tedavisinde infrared koagulasyon ve lastik bant ligasyon. Akademik Gastroenteroloji Dergisi, 5(3), 179 - 183.
Chicago	YAKARYILMAZ Fahri,GÜLİTER Sefa,ÖZKURT Zübeyde,KELEŞ HATİCE,EBİNÇ Fatma Erken evre hemoroid tedavisinde infrared koagulasyon ve lastik bant ligasyon. Akademik Gastroenteroloji Dergisi 5, no.3 (2006): 179 - 183.
MLA	YAKARYILMAZ Fahri,GÜLİTER Sefa,ÖZKURT Zübeyde,KELEŞ HATİCE,EBİNÇ Fatma Erken evre hemoroid tedavisinde infrared koagulasyon ve lastik bant ligasyon. Akademik Gastroenteroloji Dergisi, vol.5, no.3, 2006, ss.179 - 183.
AMA	YAKARYILMAZ F,GÜLİTER S,ÖZKURT Z,KELEŞ H,EBİNÇ F Erken evre hemoroid tedavisinde infrared koagulasyon ve lastik bant ligasyon. Akademik Gastroenteroloji Dergisi. 2006; 5(3): 179 - 183.
Vancouver	YAKARYILMAZ F,GÜLİTER S,ÖZKURT Z,KELEŞ H,EBİNÇ F Erken evre hemoroid tedavisinde infrared koagulasyon ve lastik bant ligasyon. Akademik Gastroenteroloji Dergisi. 2006; 5(3): 179 - 183.
IEEE	YAKARYILMAZ F,GÜLİTER S,ÖZKURT Z,KELEŞ H,EBİNÇ F "Erken evre hemoroid tedavisinde infrared koagulasyon ve lastik bant ligasyon." Akademik Gastroenteroloji Dergisi, 5, ss.179 - 183, 2006.
ISNAD	YAKARYILMAZ, Fahri vd. "Erken evre hemoroid tedavisinde infrared koagulasyon ve lastik bant ligasyon". Akademik Gastroenteroloji Dergisi 5/3 (2006), 179-183.