2021年11月10日星期三

Various questions about hemorrhoid surgery in doctor's notes

Xiao Zhang is a reader of the bathroom, squatting for more than an hour at a time. After defecating once at the end of September, he found that the meat leaked from his anus, swollen like dumplings, painful and motionless. Xiao Zhang bought hemorrhoids for external use, and there will be no relief for several days. Finally, he failed to overcome his family's advice and came to the anorectal and clinic of the people's Hospital of Suzhou high tech Industrial Development Zone. During the physical examination, the doctor told Mr. Zhang that the steamed bread was inflamed hemorrhoids. The inflamed hemorrhoids were embedded in the anal door, and some tissues rotted to death. After hospitalization, after the anti-inflammatory swelling subsided, anorectal and director Tang Yongqiao successfully implemented the "internal hemorrhoid elastic division ligation and external vaginal resection" to solve the pain.

If you ask the medical history, you will find that patients with acute hemorrhoids like Mr. Zhang have clinical symptoms before the onset. The history of recurrent massive bleeding and anal tumor bleeding, but they lack self attention and ignore the diagnosis and treatment of the disease. Affected by the traditional concept, many patients believe that surgical intervention is needed until the hemorrhoids are serious. However, with the update of medical technology, the surgical indications of hemorrhoids are being readjusted.

What kind of patients need surgical intervention? 1、 Repeated bleeding of internal hemorrhoids: internal hemorrhoids are in the anus. The main symptom is painless massive bleeding, which usually occurs intermittently. If there is long-term massive hemorrhage, but the effect of drug conservative treatment is general, patients with anemia and other complications caused by massive hemorrhage should undergo surgical intervention as soon as possible. 2、 When hemorrhoid nucleus falls off and anus is uneven: Anal mass falls off without obvious pain. However, if hemorrhoids affect life, you can't wipe paper. When it causes anal itching and eczema, you should have surgery as soon as possible. 3、 Acute attack of hemorrhoids: thrombotic external call, inflammatory external call, imprisonment of mixed hemorrhoids, emergency operation or operation after detumescence treatment when necessary; 4、 Elderly patients with hemorrhoids: clinically, many elderly patients with hemorrhoids have massive bleeding attack, hemorrhoid nuclear inflammation and necrosis, are old, and are often complicated with chronic diseases such as coronary heart disease, hypertension and atrial fibrillation. The operation contraindication and operation risk are high, and the hemorrhoid operation can not be carried out in time, resulting in the pain of patients

Therefore, even if hemorrhoids last for a long time, people without symptoms should also choose the date of operation. Don't wait until you are old to think of the operation. David Asher, northern exposure (American television) if the hemorrhoid core is small, the surgical injury is less, the recovery is faster, and the subsequent pain will be reduced. On the contrary, patients have great pain and long recovery time after operation. In today's diversified hemorrhoid surgery, we abandon the traditional concept and do not operate until the onset of hemorrhoids.

What is the way of anorectal and hemorrhoid surgery in the people's Hospital of Suzhou high tech Industrial Development Zone? 1. Injection of sclerosing agent for internal hemorrhoids: the bleeding of internal hemorrhoids and elderly hemorrhoids cannot be removed, and the hemostatic effect is good. (2) Internal hemorrhoid elastic line ligation) is the mainstream operation for the treatment of internal hemorrhoids at the anorectal boundary. While ligating the hemorrhoid core, ligate the hemorrhoid mucosa and strengthen the suspension effect of anal pad. It has less wounds, fast recovery time and low long-term recurrence rate. It is suitable for patients with internal hemorrhoids and patients who cannot undergo resection due to mixed hemorrhoid bleeding. 3、 Ultrasound guided hemorrhoid artery ligation: cut off the blood supply of hemorrhoid nuclear artery to reduce the probability of bleeding and hemorrhoid recurrence after hemorrhoid surgery. It is used as an adjuvant treatment for hemorrhagic hemorrhoid surgery, with almost no trauma. 4、 External incision and internal suture of mixed hemorrhoids: traditional operation of mixed hemorrhoids, typical operation and low recurrence rate. 5. External hemorrhoidectomy by internal hemorrhoids elastic Division: it is applicable to most patients with mixed hemorrhoids. Compared with traditional surgery, it greatly reduces incision, reduces the probability of postoperative massive bleeding, reduces patient pain, reduces recurrence rate and shortens hospital stay. 6. Hemorrhoid mucosal circumcision and suture (PPH): some hospitals publicize minimally invasive hemorrhoid surgery, and patients may be uncomfortable after surgery. Therefore, many hospitals at home and abroad are gradually abolishing this operation method. Only for patients with polar annular mixed hemorrhoids and rectal prolapse.

Is the operation reliable? In the process of anorectal and outpatient diagnosis and treatment, many patients who believe in laser surgery said on the Internet were found. Tang Yongqiao, anorectal and director, said: "so far, there is no formal literature report on hemorrhoids laser surgery. Some remote small clinics may have done laser surgery in the past, but laser is only a means to eliminate hemorrhoids. We can't blindly recommend patients who reduce wounds and alleviate patients' pain like scalpel and surgical resection."

The anorectal Department of the people's Hospital of Suzhou high tech Industrial Development Zone performs hemorrhoids surgery all year round. There are a variety of operation methods. Different treatment schemes should be formulated for different patients and types of hemorrhoids. Mild patients can be discharged from the hospital in 2 ~ 3 days, and seriously injured patients can be hospitalized in 5 ~ 7 days. The key is the type of hemorrhoids and postoperative recovery (several).

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