Hemorrhoids surgery to remove the inflamed nodes
Hemorrhoid treatment involves several options. In the absence of the effectiveness of usual drug therapy the doctors recommended radical methods to get rid of this unpleasant disease. In acute hemorrhoids increases the risk of complications after surgery. Patients are advised to undergo the necessary tests, wait for the remission and stabilization, and only then make the decision on expediency of operation.
Indications and contraindications
The initial stage of hemorrhoids are not an indication for surgery. In some cases, the patient can be offered a less traumatic intervention. Surgical methods are effective and justified in cases of severe complications and the development of hemorrhoids to stage 4, when there are the following complications:
- the prolapse and parts of the rectum;
- pinched and thrombosis hemorrhoids;
- frequent and heavy bleeding;
The regular release of large amounts of blood dangerous anemia. Loss of nodes creates favorable conditions for infection in the perianal region. The mucus secreted by the inflamed sites, irritated and reduces the protective properties of the skin. As a result, the body is threatened by infection and tissue necrosis. In addition, the patient experiences excruciating pain and itching, which are forced to make a decision about the radical measures against the disease.
Removal of hemorrhoids is a complex operation, so there are a number of contraindications for. Patients contraindicated for surgery, if there are the following complications:
- heart failure;
- ulcers, gastritis and other diseases of the gastrointestinal tract;
- diabetes mellitus (poorly compensated);
- pregnancy and lactation.
Preparing for surgery
Surgery to remove hemorrhoids is conducted with full awareness of the patient about the details of treatment and postoperative period. You need to understand and appreciate the risks and consequences of surgery. Only then begins preparing the patient for surgery.
The preparation process includes the following steps:
- diet and taking laxatives medication, purpose of enema;
- testing of blood, urine, etc.;
- an examination by a proctologist, and the passage of more accurate methods of diagnosis;
- identify risk factors and contraindications.
How is it performed
Removal of hemorrhoids is it painful? Depending on the complications and the technique selected, the patient is General or local anesthesia. In the first case, the patient will not feel anything, the pain goes away before the anaesthetic ceases to act.
In the case of local anesthesia anesthesia solution of novocaine and adrenaline. Performed first circular blockade of the skin, then anesthetized adrectal fiber. When there is complete relaxation of the muscles of the anus, the doctor maximally stretches the sphincter. For fixing the contours of the anus terminals. Thus, access is provided to hemorrhoidal inflamed bumps that are easily excreted out and removed according to the chosen methodology.
Classification of operations
Today, doctors practice several types of operations to remove hemorrhoids. It is a modern surgical techniques in which the usual scalpel is not applicable. These methods have no contraindications, do not leave traces on the body of the patient.
- ligation latex rings;
For reviews of doctors and patients, these operations are characterized by rapid recovery and low probability of complications.
Among the classic surgical techniques of removal of hemorrhoids are the following:
- open and closed hemorrhoidectomy according to the Milligan – Morgan;
- hemorrhoidopexy for Longo.
Both types of operations involve the preliminary preparation of the patient in the hospital. The doctor determines the appropriate type of anesthesia appropriate to the complexity of the operation.
Given the stage of the disease and the presence of complications, doctors determine the most effective method of treatment. First and second stage of hemorrhoids include conservative treatment with medication, application of sclerotherapy and photocoagulation. At the stage of hair loss inflamed nodes effective departuredate and ligation. In the fourth stage provides for the operation by the method of Longo or Milligan – Morgan.
There are also more rare methods of surgical treatment of hemorrhoids:
- the method according to the Sklifosovsky. Runs tying the base of site strong thread, after which the blood flow in it stops and he dies;
- the method according to Martynov. The site is tied off, and further it is cut off;
- the reception of Whitehead indicated for patients with severe complications. In this case cut off the affected portion of the rectum, and the edges of healthy tissue are sewn to the anus.
Severe forms of hemorrhoids require radical treatment, method Longo used more often than others. The procedure lasts no more than 30 minutes, characterized by a quick recovery period, and its implementation does not require special tools. The method consists in removing pathological lesions and the district of the mucosa in the rectum. The surgery is performed under local or General anesthesia.
The patient has no postoperative scars or wounds. The only drawback of surgery is the inability to remove external education. The cost of surgery is not available to each patient.
Treatment according to the method of Milligan – Morgan
Operation hemorrhoidectomy is considered the most unpleasant. Held on the 4th stage of the disease, when there is a part of the rectum. Open hemorrhoidectomy is performed in the presence of complications in the form of cracks or abscess. Deletes nodes and peripheral part of the mucous membrane, is used kathoey seam.
The lack of manipulation – duration, the risk of profuse bleeding, difficult and long rehabilitation. The method of Milligan – Morgan is a subspecies of – parks method, which involves the removal of inflamed nodes without the ring part of the mucosa. Unconditional advantage of the procedure is to completely treat the causes of disease and restore the normal functioning of the rectum.
Recently laser surgery has become widespread. The method consists in the burning of a node inside a laser beam, which reduces the size of the formation. When used for external entities, they simply cut off the beam. After the procedure the patient goes home, does not require much recovery time.
According to the reviews of patients, the procedure is absolutely painless and leaves no residue on the skin. During the operation, there is bleeding, because the vessels instantly prizhivayutsya. In the presence of fistulas, bleeding or other complications surgery laser is performed without changes in technology. The disadvantages include:
- the high cost of the procedure;
- the probability of relapse.
Surgery for hemorrhoids is successful, but after a time appear certain complications:
- pain. To relieve pain narcotic analgesics are appointed;
- urinary retention. The patient catheter is placed;
- bleeding. Because when you remove hemorrhoids injured mucosa of the rectum, under the action of fecal matter and cause cracks, and bleeding occurs;
- emotional stress. Often after surgery, patients are afraid to be emptied, which causes a delay of a chair. In this case, the patient is prescribed a special diet and laxatives;
- incompetence of the anal sphincter. In the case of successful surgical interference, this phenomenon is rarely seen. However, the changes of the walls of the colon leading to loss of part of the rectum out. Doctors prescribe repeated surgical or conservative treatment;
- narrowing of the anal canal. Improper suturing stricture is observed, which manifests itself even after 2-3 months after surgery;
- the suppuration. When getting into the wound pathogens immediately after surgery, there is the appearance of purulent inflammatory processes. Appointed anti-inflammatory and antibacterial agent;
- fistula – an unpleasant complication that appears few months after treatment. Often are medication therapy, rarely radical treatment.
The postoperative period
Depending on the complexity of the treatment, the patient after some time returns to normal life. Doctors recommend timely processing of the wound and follow a special diet to unpleasant sensations disappeared within 1-2 weeks of the recovery period.
In the early days patients report severe pain during defecation. After 1-2 weeks the pain disappear, otherwise you should consult a doctor. Prolonged pain is a sign of complications.
Patients special diet is prescribed before and after surgery. Food follows several principles:
- richness of useful substances;
- after surgery it is recommended that a fractional power in small doses;
- products must contribute to the formation of soft stools.
Not to cause a bowel movement, the doctors suggest the first day to refuse to eat. Also after surgery you should refuse products that cause flatulence in the intestine:
- Kale, sorrel, apples, dates, raspberries and other foods that contain glubokovyemchatye fiber;
- grapes, nuts, raisins, black bread;
- kvass and carbonated beverages;
- smoked, spicy, canned foods;
- alcoholic beverages.