To avoid recurrence of hemorrhoids after PPH hemorrhoid surgery, one should prevent and treat constipation, and the other should pay attention to life conditioning.
Note the following:
(1) The choice of cases is mainly hemorrhoids in stage Ⅱ-Ⅳ. The larger part of external hemorrhoids cannot solve the symptoms of external hemorrhoids, so this operation is not suitable.
(2) Strict preoperative bowel preparation and strict aseptic operation are the key to preventing infection.
(3) The pulling of the non-injury forceps should be gentle, and the tear of the anal margin is the main cause of postoperative pain.
(4) The purse-string suture should be accurate in depth, evenly stepped, and make the purse-string suture on a cross section. The width of the tissue to be removed and the height of the anastomosis can be controlled according to the size of the hemorrhoids and the degree of prolapse. Double-layer wallets should be used when necessary, and the two wallets should be kept parallel and not too wide apart.
(5). The start and end points of purse-string suture can be made at the larger points of the hemorrhoids. The start and end points often cut more tissues, so the effect of hanging and blocking the blood supply will be better.
(6) The closing time of the stapler should be slightly longer after firing to ensure a tight anastomosis and reduce bleeding during the anastomosis
(7) Check the anastomosis carefully. If there is a pulsating bleeding spot, you should make a "8" stitch under the eyes until the bleeding stops.
(8) Coating the anastomotic stoma with a traditional Chinese medicine cytrimide which is astringent and hemostasis can help prevent anastomotic bleeding.
(9) After placing the exhaust pipe for 24 hours, it can be observed whether there is bleeding and the amount of bleeding and can reduce the flatulence.
(10). Ensure adequate intake of water. Adequate intake of water can achieve the purpose of softening feces and has a better effect of preventing constipation. Make sure to drink 1000ml of water every day. Drinking cold boiled water every morning can stimulate the stomach-colon reflex and achieve the purpose of promoting bowel movement, but it is necessary to adjust the temperature of the water appropriately according to the season.
(11). Sufficient dietary fiber intake. The diet should contain sufficient fiber. The dietary fiber intake for normal defecation in adults is 20g per day. Cellulose is hydrophilic and can absorb water, making food residues swell and easily advance; residues can stimulate bowel movements, which is good for stimulating bowel movement and defecation reflex. In addition, intake of multi-fiber foods such as bananas, dietary fiber drinks, fruits, vegetables or bamboo shoots, oatmeal, and bran can promote bowel movements.
In short, PPH surgery is a new technique for the treatment of hemorrhoids. Through the observation of 5000 cases, we believe that this operation has good curative effect, simple and safe operation. Compared with traditional operation, it has the advantages of reducing postoperative pain, reducing postoperative bleeding, shortening the course of disease, and better protecting anal function.