This is a very serious case of mixed hemorrhoids, circular mixed hemorrhoids.
Although minimally invasive PPH surgery is touted in the society, PPH is expensive, but it is not suitable for everyone.
For such severe prolapsed mixed hemorrhoids, it is difficult to use PPH alone, and it often requires surgical resection.
However, a part of the larger mixed hemorrhoids is surgically removed, and the remaining part will be more severely swollen due to surgical stimulation, even more swelling than the cut part.
Therefore, PPH is not a panacea!
Therefore, the most basic manual resection of the huge ring-shaped prolapsed mixed hemorrhoids is the key to testing the basic skills of the surgeon.
In response to such cases, I gave up the minimally invasive PPH surgery originally planned, and chose the most primitive, thorough, and most basic operation of the anorectal surgeon: the mixed hemorrhoid external stripping and internal ligation operation. The effect of the operation was excellent, and a one-time radical cure was achieved. The patient stated that the slight pain was tolerable and no painkillers were needed. No infusion, no injections, a little reddish discharge, no massive bleeding. She was discharged from the hospital the next day after the operation, without affecting driving, going to work, or defecation. There was no skin defect in the operation area, the anal canal epithelium was well protected, and the skin bridge had no edema.
Our gastrointestinal surgery is good at such mixed hemorrhoid surgery. The general procedure is:
1. First complete all the inspections in the outpatient clinic, and ask the anesthesiology department to assess the anesthesia risk;
2. Then find the surgeon to make an appointment for day ward surgery;
3. Oral lactulose oral liquid a few days before surgery to avoid anal bleeding caused by dry stool after surgery. A few days before the operation, use hot water to sit in the bath, Ma Yinglong hemorrhoid ointment will be absorbed into the anus to promote the reduction of mixed hemorrhoids, which is beneficial to the operation;
4. Do not eat on the morning of the operation and come to the hospital on an empty stomach. Hospitalized on the same day and operated on that day. Anesthesia is divided into spinal anesthesia and general anesthesia. Intraspinal anesthesia is convenient and cheap, and general anesthesia is comfortable, but more expensive.
5. Prevent the use of antibiotics once during the operation, and encourage the patient to defecate after the operation. If the first bowel movement is smooth, there is no obvious bleeding, and no obvious pain, the patient will be discharged from the hospital within 24 hours;
6. After being discharged from the hospital, the patient will sit in hot water 2-3 times a day, with hot water, yes, only hot water is sufficient, without any medication. The purpose of sitz bath is to rely on the temperature of hot water to promote local blood circulation and wash away the sticky secretions on the wound. After taking a bath, use Ma Yinglong hemorrhoid cream to absorb the anus. Remember to buy sanitary napkins (for male and female patients). Sanitary napkins can prevent anal secretions and hemorrhoid cream from soiling underwear.
7. After leaving the hospital, you can drive or work in the office. Long squatting is not recommended. Encourage the levator.
8. If you have dry stool, painful defecation, or heavy stool bleeding, you need to return to the hospital and contact the doctor in time.