2020年9月10日星期四

hemorrhoids how to treat,Original Chapter 6 How to operate hemorrhoids?

    Many friends of patients often ask: "What kind of surgery is better for my hemorrhoids?" I now summarize some common surgical treatments for hemorrhoids as follows:

    (1) Surgical indications: conservative treatment is ineffective, hemorrhoids prolapse, severe bleeding, large fibrosis, internal hemorrhoids, injections and other poor treatment, combined with anal fissure, anal fistula, etc., surgery is necessary.

    (2) Principle of operation: Reposition the prolapsed anal cushion through surgery, and preserve the structure of the anal cushion as much as possible, so as to minimize the effect of fine bowel control after the operation.

    (3) Surgical method: ①Exfoliation of thrombotic external hemorrhoids: It is suitable for patients whose pain does not relieve or the mass does not shrink after conservative treatment of thrombotic external hemorrhoids. ②Traditional hemorrhoidectomy-external stripping and internal ligation: definite curative effect, low cost, greater pain, longer healing time, and often complications. ③PPH surgery: stapler hemorrhoids and rectal mucosa circumcision and nailing. It is mainly suitable for prolapsed type III-IV degree mixed hemorrhoids, circular hemorrhoids, and partial hemorrhoids with severe bleeding. The mechanism of PPH in the treatment of prolapsed hemorrhoids: circular excision of the 2 to 3 cm lower rectal mucosa and submucosal tissue to restore the normal anatomical structure, that is, the anal cushion return; the resection of the submucosal tissue blocks the blood from the hemorrhoidal artery to the hemorrhoid area Supply, so that postoperative hemorrhoids atrophy. Compared with traditional hemorrhoidectomy, PPH surgery has shorter operation time, less postoperative pain, faster recovery and fewer complications, but the equipment is more expensive. ④ Hemorrhoid "stapling" surgery: Using the principle of PPH surgery, manual sutures are used instead of PPH staplers, which has the advantages of PPH surgery and lower cost, but the surgery is time-consuming and difficult to operate.

    Which type of surgery is suitable depends on the patient's condition. But it should be fine, minimally invasive, and painful.

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