2020年10月26日星期一

hemorrhoids ligation,Hemorrhoid artery ligation

    Hemorrhoid artery ligation (under Doppler guidance) surgical process: Lidocaine local infiltration anesthesia or sacral anesthesia, the patient lies on the left side. The Doppler anoscope is inserted into the rectum, the probe is rotated on the tooth line 2-3CM to find the artery, and the "8" is sutured with a 2-0 absorbable suture. After a circle, the anoscope should be moved back 0.5cm and repeat, ensuring that the suture is at least 0.5cm away from the tooth line. Cut off the skin tags.

    Clinical efficacy: According to the clinical report of relevant medical institutions in early 2007, a total of 22 patients with hemorrhoidal artery ligation were found and ligated 4-8 hemorrhoidal arteries under the guidance of Doppler. As a result, 21 cases complained of disappearance of symptoms, 1 case improved significantly, and 1 case 20 The constipation disappeared after the operation. The postoperative stool time in 4 cases was significantly shorter than the preoperative stool time. No cases of anal fistula, anal stenosis or incontinence were found.

    Expert comment: Doppler-guided hemorrhoid artery ligation is a minimally invasive surgery. Most surgical patients do not need analgesics and return to daily life quickly. Because there is no real surgical wound, the trauma is small and the hospital stay is significantly reduced.

    Treatment mechanism of DGHAL:

    A: After ligation, the arterial blood flow is reduced, the pressure in the anal cushion is reduced, hemorrhoids atrophy, bleeding and pain stop. It is conducive to hemorrhoid atrophy and ultimately determines the reduction of prolapse. The whole process supports the "high pressure anal cushion theory".

    B: During the operation, the rectal mucosa and hemorrhoids were directly sutured and fixed on the muscle layer to prevent the anal cushion from moving down.

    C: The bleeding vessel is blocked by suture.

    Indications: 1 1; Internal hemorrhoids of degree 2

    2 Internal hemorrhoid bleeding-immediate results

    The reactive dilation and congestion of the hemorrhoidal artery should be a reaction to the injury of the anal cushion. After the hemorrhoidal artery is ligated, the anal cushion atrophy will cause other problems, such as decreased sensory function. Because this surgical method is only 3-5 years old. Awaits long-term follow-up. Need for medical support.

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