In the forum, patients often mentioned the problem of anastomotic stenosis after PPH. Based on clinical observation, I summarized the problem of anastomotic stenosis as follows: At the same time, I also invite experts and colleagues to discuss:
There are two types of anastomotic stenosis after PPH: absolute stenosis and relative stenosis. 1. Absolute stenosis: the diameter of the anastomosis becomes smaller.
Causes: Postoperative excessive local irritation and severe scar formation led to the reduction of the diameter of the anastomotic stoma, which is often related to the patient’s own scar physique or the number of bowel movements and irritation after surgery, and more bleeding during the operation. ；
Preventive treatment: smooth the bowel movement, so that the patient develops a regular bowel habit; treatment requires complete relaxation of multiple narrow scars in the anastomosis under anesthesia.
2. Relatively narrow: that is, the diameter of the anastomotic stoma has not changed, but due to other factors, the diameter of the anastomotic stoma is relatively smaller
Causes: mostly due to residual rectal mucosal prolapse on the anastomotic stoma after surgery, and the loose rectal mucosa is sleeved into the stoma to form a relatively narrow stoma;
Preventive treatment: intraoperative preventive injection of sclerosing agent in the loose mucosal area of the anastomosis, and sclerosing agent injection or loose mucosal ligation according to the situation after the operation