Mixed hemorrhoids refer to the simultaneous varicose, enlargement, and congestion of the inferior and inferior venous plexus located in the same part of the rectal tooth line, communicating and anastomosing each other, and disappearing of the intersphincteric groove. The surface of the hemorrhoids above the tooth line is the rectal mucosa, and the surface of the hemorrhoids below the tooth line is covered by the skin of the anal canal, that is, a whole formed by the internal hemorrhoids and the external hemorrhoids is called mixed hemorrhoids.
The symptoms of mixed hemorrhoids have the characteristics of both internal and external hemorrhoids. Under normal circumstances, internal hemorrhoids occur first, and then external hemorrhoids due to varicose veins. It mostly occurs at 3, 7, and 11 o'clock positions. Therefore, the diagnosis is not difficult. As long as the patient is instructed to make defecation movements and struggle with the anus during the examination, the internal hemorrhoids can quickly prolapse or congestion and bulge.
Mixed hemorrhoids are a common disease in anorectal diseases and can occur at any age except for children. Mixed hemorrhoids are the main symptoms of hemorrhage and prolapse, which bring a lot of pain and inconvenience to the patient's life and work. Long-term blood in the stool makes the human body weak, and even produces chlorosis, dizziness, vertigo, fatigue and other anemia symptoms. Mixed hemorrhoids can generally be divided into the following categories.
The main symptoms of mixed hemorrhoids are:
①Blood in stool: bloody or ejected blood in stool, bloody red, not mixed with stool.
② Swelling and pain: The anus has a falling or foreign body sensation, and the internal hemorrhoids are easily prolapsed when the stool is forced.
③Prolapse: Because internal hemorrhoids often prolapse outside the anus, the mucous membrane is stimulated, and mucus secretion is greatly increased, which can cause the perianal skin to be moist and unclear, itching, inflammation, or eczema.
The PPH technique is also known as "circumcision of hemorrhoids", which is a new technique based on the new understanding of the pathogenesis of hemorrhoids caused by anal pad disease. The use of a stapler to treat annular prolapsed hemorrhoids is an anastomosis procedure for internal hemorrhoids and annular mixed hemorrhoids, mainly internal hemorrhoids, without destroying the normal physiological function of the anal cushion, significantly shortening the operation time and greatly reducing postoperative pain.
How does PPH treat mixed hemorrhoids?
PPH surgery uses a special instrument called a "PPH stapler" to make a circular resection of the prolapsed rectal mucosa above the hemorrhoids. During the operation, first open the anus and suture the rectal mucosa about 4 cm above the dentate line (the junction between the rectum and anal canal). Then insert the PPH stapler into the anus. The stapler can tape the prolapsed mucosa It only takes about half an hour to remove it. Because the rectal mucosa above the dentate line is innervated by painless nerves, the patient has almost no pain after the operation; and because the operation not only removes the rectal mucosal prolapse zone, but also blocks the terminal anastomotic branches of the arteries and veins of the rectum, eliminating The root cause of hemorrhoids is found, and it has a very ideal therapeutic effect on internal hemorrhoids. It has the characteristics of quick effect, quick recovery and no pain after operation.
Technical advantages of PPH for hemorrhoids:
PPH has great advantages over traditional surgery, and its main advantages are shown in the following aspects:
1. Safety: There is no need to remove the anal pad, and the normal function of the anus is preserved to the greatest extent to avoid complications such as anal stenosis and anal incontinence.
2. Painless: Pull back the hemorrhoids that have prolapsed from the anus, and cut off the blood vessels that provide blood to the hemorrhoids, without damaging the perianal skin, so there is almost no pain after the operation.
3. Less trauma and quick recovery: The circular stapling of the mucosa is a non-open wound, with less bleeding, eliminating the trouble of dressing change after surgery, and returning to normal life quickly.
4. Scope of diagnosis and treatment: circular hemorrhoids, multivalve hemorrhoids, huge isolated hemorrhoids, internal hemorrhoids, external hemorrhoids, circular mixed hemorrhoids, incarcerated hemorrhoids, etc.
5. Suitable for: Because of less damage, it is especially suitable for middle-aged and elderly people, white-collar workers who pay attention to efficiency, and those who have relapsed in traditional treatment, and patients with mild prolapse and rectal mucosal prolapse.