mixed hemorrhoidectomy

The clinical symptoms of mixed hemorrhoids are the same as those of internal and external hemorrhoids, and they are mainly caused by blood in the stool and pain of anal swelling. The initial is blood staining of hand paper, occasionally blood and ejection, and in the late stage, the nucleus is prolapsed and light. Those who can pay back on their own, the heavy ones are sent back by hand, local foreign body sensation, and also see constipation, or bowel movements. The inner and outer nucleus are continuous and become a whole called mixed sputum, which is the most complicated one in acne. Its external hemorrhoids have connective tissue, varicose veins, thrombosis, and inflammation. There are three types of vasospasm, venous tumor and fibroid in the internal hemorrhoids, which can be divided into three stages according to their severity. There are different treatments for each stage. Treating diseases: mixing Indication 1. Internal hemorrhoids that are repeatedly bleeding after injection therapy or sputum treatment. 2. The internal hemorrhoids can be repaid or can not be returned. Contraindications 1. Infection with internal hemorrhoids, even when there is edema, ulcer, necrosis, thrombosis, the tissue is fragile, it is not easy to suture during operation, and the suture is easy to fall off after operation. The operation area can increase scars due to infection, causing anal canal stenosis. Surgery is performed after the infection has subsided. 2. Meat plaque caused by portal hypertension, heart failure or compression of the inferior vena cava should not be removed. 3. It is not suitable for surgery during pregnancy and menstruation. Preoperative preparation 1. Do a good physical examination, pay attention to pregnancy, portal hypertension, intra-abdominal tumor or rectal cancer. Local examination should pay attention to the abnormality of the sphincter function, the local condition of the sputum and the presence or absence of arterial pulsation. 2. Enter the low slag diet 1 day before surgery. 3. Soap water enema 1 time before surgery. The enema should be cleaned 2 to 3 hours before surgery (if you can drain your stool, you can not enema). Surgical procedure The stone removal position. Cut the skin in a V-shaped section in the lateral malleolus and separate the external iliac vein plexus with a hemostasis or scissors to the top of the tooth line. Then, the inner edge of the inner iliac crest is made into an eight-shaped incision at the upper end of the medial condyle, and the inner iliac vein plexus is continued to be separated until the upper end of the incision The rectal mucosa and connective tissue at the upper end of the medial malleolus were clamped with a nucleus clamp or a curved hemostat. The suture was ligated with a 7-gauge thread, and the iliac venous plexus was cut and wrapped with Vaseline gauze and dressing. complication 1. Bleeding: There are two reasons for postoperative bleeding in internal hemorrhoids. The former is caused by slippage due to tight knots; the latter occurs about 7 to 10 days after surgery, due to infection at the ligation site. Due to the action of the anal sphincter, the blood flows back into the intestine without going to the anus, so the phenomenon of "staining red dressing" cannot be found clinically. Therefore, this "acute bleeding" is often not easy to find early. 2, stenosis: careful surgical operation and early anal canal expansion can prevent anal canal stenosis. The stenosis can be at the anal rim, the tooth line or the tooth line. Stenosis at the anal margin is mainly due to excessive removal of the skin and mucosa of the anal margin, causing the wound to contract and causing anal stenosis. The scar is often accompanied by an anal fissure, which is caused by tearing during defecation. The use of manual methods and instruments to expand the anus is ineffective, often requiring multiple surgical treatments. 3, urinary retention: urinary retention is the most common complication after sputum or other anal canal surgery, prevention of urinary retention.

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