Hemorrhoids after surgery: patient testimonials
- 23 Jul 03:15
- Hemorrhoid Treatment
To get rid of such a serious illness as hemorrhoids is quite difficult, especially at the onset of therapy in the onset stage of the disease. In such a situation, some conservative methods that reduce the symptoms of the disease will not be sufficient, radical operationaltreatment is required. Only this way can we stop the progression of the pathological process, eliminate physical and moral suffering for a long time and improve the quality of life of the patient.
Table of contents
- 1 Anatomical basis of pathology
- 2 What is an
- 3 disease? Who needs surgery
- 4 Preparation for operation
- 5 Types of operations
- 6 Traditional surgery
- 7 Longo method
- 8 Post-operative period risk
Anatomical basis of pathology
For the correct idea of hemorrhoids, you need to know the anatomical basis of the disease. Each person in the rectum and the anus under the mucous membrane in a loose layer of connective tissue are hemorrhoidal education( cavernous corneas).It is established that the main function of these formations is participation in the process of accumulation and maintenance of fecal masses. At certain moments, caverns are filled with blood and anesthetized anal canal, as necessary, they can be reduced in volume so as not to interfere with the act of bowel movements. Hemorrhoid plexuses or cavities are maintained in place by a connective tissue coupling apparatus( Parx bundle).
When combining genetic features and the wrong lifestyle, there is a disturbance in the balance between the influx and outflow of blood in a small pelvis, the cavities are strongly stretched, their walls lose elasticity, resulting in a hemorrhoidal node.
Proctologists usually define three sets of nodes in typical locations. From the anatomical point of view, hemorrhoids are divided into external and internal. Hemorrhoids are constantly exposed to pressure from the feces passing, which gradually leads to the stretching of their maintain ligaments and regular loss of cones outside the anal sphincter.
What is the disease
Hemorrhoids relate to chronic diseases, which occurs with periods of lulling and exacerbation. Characteristic complaints of patients are:
- discomfort and heaviness in the anus;
- bleeding of varying intensity;
- painful itching and burning;
- dropdown nodes.
During lull, the symptoms of the disease are poorly expressed. Periods of exacerbation( acute hemorrhoids) are characterized by a vivid clinical picture associated with the development of inflammation and( or) thrombosis in hemorrhoidal nodes( they become dense and very painful).This increases the risk of bleeding, necrosis in the nodes and surrounding tissues until sepsis. Most often at this time the patient ripens to visit the proctologist. In the acute period, the patient is given a conservative treatment.
For the convenience of doctors in the choice of treatment tactics, distinguish between the four main stages of internal hemorrhoids:
- on the first node is outside the anal sphincter, the patient is anxious because of the constant allocation of fluid and mucus, a feeling of a foreign subject and overcrowding in the rectum;
- in the second stage, the nodes begin to periodically drop out when the bowels are empty or lifting up heavy things, but they do so independently, may bleed slightly;
- third stage - it is the loss of cones at any stress, coughing, sneezing, movements, correct them only forcefully with their own hands for a short time, the patient is concerned about severe pain during bowel movement, sitting, walking, maceration of the skin around the anus, may joininfection;The fourth stage of the
- is the hemorrhoids that are started, when the patient needs surgical treatment in the hospital, the nodes do not work, their inflammation can easily occur, inflammation develops up to necrosis, thrombosis, high risk of bleeding, attachment of the infection to the development of paraproctitis and even sepsis.
Who needs operation
Do you have hemorrhoids?
Mikhail Rotonov: "The only remedy that is suitable for proper hemorrhoids treatment at home and which I could recommend is. .." Read More>.
The priority direction in the fight against hemorrhoids is conservative treatment. Today in the arsenal of doctors a large assortment of modern means of local and general therapy of this ailment, which allow you to quickly and effectively eliminate the main manifestations of the disease and return the patient to a healthy life. However, these methods do not act on the cause of the disease.
At certain stages of development and especially the course of the disease in some patients, conservative methods are ineffective, then the only and reliable way to get rid of hemorrhoids remains operative treatment.
The main indications requiring surgery are:
- internal hemorrhoids of stages 3 and 4, when there is no effect on conservative therapy, carried out for at least three months in a row, is there a tendency for further progression of the pathological process;
- the emergence of relapse after hemorrhoids removal by non-invasive methods;
- recurrent loss of hemorrhoids with high risk of complications;
- frequent small spotting or rare abundant bleeding leading to anemia;
- acute thrombosis and inflammation with severe pain syndrome;
- combination of hemorrhoids with other diseases of the rectum - cracked hindquarters, polyps, acute paraproctitis, fistulae.
Radical surgery is contraindicated in the presence of the patient's concomitant diseases and conditions:
- endocrine diseases( adrenal insufficiency, decompensated diabetes mellitus);
- ulcerative intestinal defects;
- acute intestinal infections;
- cardiac and pulmonary insufficiency;
- HIV and other immunodeficiencies;
- Pregnancy period;
- Cancer Disease;
- aging patient's age( over 70 years).
In such situations, alternative methods are used, conservative treatment continues until the moment appropriate for the operation( postpartum and breastfeeding, after healing of the ulcer, etc.) is continued.
Preparing for the operation
Before you decide on the operation, the patient must undergo an examination, hand over all necessary tests, specify all possible risks of surgical intervention, get permission of physicians of related specialties. Operative treatment of hemorrhoids is carried out in various medical institutions. It is better to choose a specialized proctologic clinic and a competent practitioner. At the same time, it will be superfluous to study the feedback of the former patients of this institution.
As preparation for the operation, the following measures are taken:
- diet correction - restriction of fatty products, beans, carbonated drinks, black bread, coarse vegetable fiber several days prior to surgery, famine on the eve of the evening and the day of the prescribed operation;
- Early treatment of inflammation in the rectum and the anus( cracks, ulcers, erosion) with the help of effective local medications;
- cleansing enema at night and in the morning or taking laxatives( fortrans).
The type and method of surgical intervention is discussed in advance by the physician and the patient.
When choosing a method, not the responses of patients undergoing surgical treatment of hemorrhoids, but on the health of a particular patient, the peculiarities of the course and stage of development of the disease, the presence of indications and contraindications are not oriented.
Assesses the possible risks of complications in the postoperative period and the possibilities of their prevention.
Types of operations
There are several types of surgical interventions. Recently, the non-invasive surgical techniques are very popular, in which the removal of hemorrhoids passes sparingly. These operations are carried out in an outpatient setting under local anesthesia or without it, with no major surgical wound, no long period of recovery. Patients like these techniques, leaving many positive reviews on forums.
Specifically, for transactions such as:
- sclerotherapy - a method of gluing the walls of the veins with a special drug introduced into an advanced vessel;
- ligation of hemorrhoidal nodes using latex rings;
- freezing( destruction of nodes) by liquid nitrogen;
- coagulation with infra-red rays;
- proximal hemorrhoidal artery ligation( decarterization method).
After a 10 or 20 minute procedure, the patient is immediately discharged home with recommendations that must be strictly adhered to in order to prevent complications. If there are several nodes or the appearance of new ones, they perform repeated operations within a month. These techniques are used for internal hemorrhoids in stages 2 and 3, preferably in young people or patients with contraindications for radical surgery.
The golden standard of proctology remains radical hemorrhoidectomy to our day. Currently, there are several ways to perform this operation:
- hemorrhoidectomy by Milligan and Morgan - by open, closed or submucosal way;
- transane excision of hemorrhoidal nodes by Longo method.
Several modifications to the operation of Milligan-Morgan are currently being used.
Different ways of hemorrhoidectomy differ in techniques of conducting, but perform one task - the removal of hemorrhoids, complete deprivation of the patient from hemorrhoids and improve the quality of his life.
The main methods of hemorrhoidectomy:
Recurrence of the disease after such treatment is not common. With proper nutrition and a healthy lifestyle, you can forget about hemorrhoids for a long time or forever. However, the relatively high risk of complications in the postoperative period, which leads to a decrease in the number of patients among patients to treat hemorrhoids in this way.
One of the most effective methods for removing hemorrhoids has been developed in the early 90s of the last century and named after the prominent Italian doctor Antonio Longo. Other names of this method are hemorrhoidopexia, mucosal-submucosal resection, stapling hemorrhoidectomy. Operative hemorrhoids treatment by Longo's method is that hemorrhoidal cones are not cut out and tightened upward after removing part of the mucous membrane. As the main tool, use a special device that seams the edges of the wound with titanium braces on the principle of stapler. There is a disarterization of nodes, after a few days they dry up and are soon replaced by scar tissue. The whole procedure lasts no more than 20 minutes. The main advantages of the Longo method are:
- restoration of normal anatomy of the anus without traumatic damage to the rectum mucosa;
- painless procedure;
- use of local anesthesia;
- is a short rehabilitation period, staying in a hospital is not more than 72 hours;
- rare complications in the postoperative period;
- minimum number of relapses;
- lack of aesthetic defects at the site of surgery;
- quick recovery of the patient - 5 days.
Operation Longo has many positive reviews, which show good near and distant prospects for this method of surgical treatment of hemorrhoids.
However, in the Longo method, as with any other, there are shortcomings:
- impossibility of operation at large external hemorrhoids;
- lack of long-term clinical observations of patients undergoing surgery many years ago;
- high value because of the need for a set of one-time tools for each operation.
are often observed. Unfortunately, radical surgery can complicate, especially when it happens after the Milligan-Morgan operation. This is due to tissue damage and due to the peculiarity of the location of the operating field in the zone of large accumulation of bacteria:
- pain - especially in the first day or two after the removal of nodes, removed by analgesics by intramuscular and rectal candles with anesthetics;
- suppuration of the perianal area - for the treatment of antibiotics administered locally and internally;
- fistula education - is in the long run, is treated by repeated surgical intervention;
- expresses narrowing of the anus, requiring plastic surgery - it is rare;
- bleeding - due to damaged stitches with hard feces in case of non-compliance with the diet and the development of constipation;
- urinary retention( more often in men) - may occur in the first day, catheterization of the bladder is performed, then the problem disappears on its own;
- loss of a part of the mucosa of the rectum - occurs rarely when damage to the neuromuscular fibers and the development of functional insufficiency of the anal sphincter, is treated conservatively or surgically;
- the development of depression, an intrusive fear of returning a hemorrhoids and a repeat operation, appoint sedative or other drugs after consultation with a psychotherapist.
In the postoperative period, strict adherence to all medical recommendations for diet, diet, and limitation of severe physical activity is of great importance. In case of impossibility to normalize the stool and get rid of constipation, the dietary measures appoint safe laxatives( dufalak, mukofalk).Must be thoroughly treated wounds. Recovery will be easier and faster if you do not break the day mode and do not hurry with a return to the old way of life. Life after surgery without hemorrhoids is a new style without bad habits, physical exhaustion and food errors.
When choosing one or another method of surgical treatment it is not necessary to buy advertising, the best way to get rid of hemorrhoids is that which is selected individually, taking into account the specific features of hemorrhoids in this patient.
Hemorrhoids refer to curable disease, it is only important to have a desire and not to bring illness to a very neglected condition.