Doctor Liu Fuyingcong led the case
Patient: Mr. Liao, male, 61 years old, from Shaoguan, Guangdong, diagnosis: acute incarcerated ring mixed hemorrhoids
Operation date: 2015-9-18 Anesthesia: sacral anesthesia + basic anesthesia
Specialist condition of the patient at the time of consultation: prolapsed ring-shaped hemorrhoids, about 6*5 cm in size, were seen at the anal margin, with obvious edema, more thrombosis, and more black necrosis at the distal end, with significant tenderness. (Picture 1)
Director Chen, an anesthesiologist, is giving the patient a sacral anesthesia (Figure 2)
After anesthesia and before the operation (Figure 3)
Thoroughly check the condition of the anus, anal canal, and middle and lower rectum before the operation, and design the surgical incision reasonably, and strive to achieve a flat anus after the operation, with uniform tension, no excessive hemorrhoid tissue remaining, no stenosis, no anal incontinence, etc.
Dr. Liu Fuyingcong and Wang Tingting's master's degree students are dedicated to performing surgery on patients (Figure 5)
The appearance of the anus after the operation: the operation design is reasonable, divided into five segments, and it is more beautiful. The operation is smooth and the hemorrhoids and thrombus are completely peeled off. The anesthesia is satisfactory. The patient has no pain at all during the entire operation. Long-acting analgesics are injected after the operation. (Picture 6)
2015-9-22 (fourth day after operation): smooth drainage of the anal wound, slight edema, no obvious pain during defecation (Figure 7)
2015-9-23 (Fifth day after surgery) The patient is in good condition, no complaints of discomfort, smooth defecation, smooth drainage of the anal wound, and slight edema. The anal margin incision can absorb the thread, and the black ligature in the anal canal and rectum can be seen Did not fall off. (Figure 8)
2015-9-29 (the 11th day after surgery) The patient recovered smoothly and well. The anal canal and rectal ligatures were completely off without bleeding.
2015-10-1 The patient recovered and was discharged. The patient and family members are very satisfied with the treatment of the Second Department of Surgery of Futian Anorectal Hospital!
2015-10-7 (19 days after the operation), the wound was reviewed after discharge. The wound was completely healed, the anus was well closed, there was no false healing, no anus stenosis, no anal feces or discharge. (Picture 10, Picture 11)
2015-10-12 (24 days after the operation), the patient returned to the clinic. There was no complaint. The anal wound was healed well and no complications occurred. (Picture 12, Picture 13)
Figure 12: Photograph when the anus is contracted and closed.
Figure 13: Photos of anal dilation and anger.
Summary: This patient is a severely incarcerated circular mixed hemorrhoid, with hemorrhoids hemorrhoids heavier, obvious edema, more thrombosis, and more necrotic tissue. The operation is difficult. Inexperienced surgeons or low-age anorectal surgeons are very difficult to perform operations. It is easy to remove too much hemorrhoid tissue and cause anal stenosis, or to remove too little hemorrhoid tissue, the postoperative edema is obvious, and the pain is more pronounced; I attach great importance to this operation, and I am very cautious during the operation. It is like protecting the anal marginal skin and anorectal mucosa. It protects my eyes like the cornea. It is no exaggeration to say that this anorectal surgeon can be said to have graduated from the operation and postoperative recovery of such severe hemorrhoid patients!