What is a hemorrhoidectomy? This is the name of the type of surgical intervention, which is often used in proctology. If a person is prescribed a hemorrhoidectomy, then the specialist should explain to his patient in more detail what the nuances of this operation are. In addition, answering the question of what is hemorrhoidectomy, the doctor should also talk about the most effective method of resolving the problem using the Milligan-Morgan method. In this article, it will be possible to get acquainted in more detail with the cases in which patients are prescribed radical removal of varicose veins in the anorectal region. But before that, let's take a closer look at what a hemorrhoidectomy is. What it is? In what cases is it prescribed? How is it done?
General description of the procedure
Currently, various pathologies of the rectum are in a leading position among other diseases of the gastrointestinal tract. Thrombosis and inflammation of hemorrhoids are observed in every fifth inhabitant on the planet. This statistic duringlargely due to the modern way of life, as well as a decrease in human physical activity. In some cases, this disease occurs with such severe symptoms that the specialist prescribes a hemorrhoidectomy to the patient. What it is? This procedure is a surgical intervention during which hemorrhoids are removed.
Indications and contraindications
When planning a hemorrhoidectomy, the patient reviews of which can be seen in this article, the specialist must necessarily evaluate the expected risks and benefits of such treatment. In parallel with this, the general condition of the patient, his age, as well as the presence of concomitant pathologies and diseases are taken into account.
In most patients with hemorrhoids, rational conservative therapy, as a rule, gives good results. But it may also happen that such a measure of treatment does not lead to stabilization of the condition. Then the patient is scheduled for surgery. In parallel with this, Morgan hemorrhoidectomy is prescribed in the following cases:
- Hemorrhoids leaking at the third or fourth stage of their development.
- Prolapse of a hemorrhoid during defecation.
- Hemorrhoidal vein thrombosis.
- The development of anemia due to constant bleeding.
There are also many different limitations of such a surgical intervention. For example, hemorrhoidectomy surgery can be a rather risky treatment that does not always work.justifies if the patient has a history of hypertension or diabetes mellitus. The advanced age of the patient is also often a contraindication for surgery.
Other contraindications for open anorectal hemorrhoidectomy include the following:
- Presence of malignant neoplasms.
- Exacerbation of acute bowel diseases.
- A bleeding disorder.
- Acute infectious process.
- Severe decompensated pathology of internal organs.
Considering the features and feedback from patients about hemorrhoidectomy, it should be noted that this operation is divided into several types.
Types of surgery
Currently, the most effective surgical method for removing varicose veins in the anorectal region is an open (classical) operation. It's called a Milligan hemorrhoidectomy. The closed type is called submucosal hemorrhoidectomy or Ferguson hemorrhoidectomy. Such an operation involves resection of the mucous membrane of the anal canal of the rectum according to the Longo method. Each of these methods has both positive and negative qualities. However, the classical method of radical intervention is the most popular. Despite this, Longo's hemorrhoidectomy may become a very good competitor in the near future.
The Morgan method is the most traumatic. It is performed exclusively under general anesthesia, thereforethe patient must be thoroughly prepared for this procedure. The undeniable advantage of this operation is the ability to remove both internal and external hemorrhoids of the rectum.
Dr. Ferguson's technique is a relatively new method of removing pathologically altered veins in the anus. Closed hemorrhoidectomy is qualitatively different from other types of surgical resolution of this problem in that after this operation, the tissues of the rectum are sutured. For this reason, wounds heal much faster after hemorrhoidectomy. Patient testimonials prove this. It is worth paying attention to the fact that the risk of complications after such therapy is, in general, small, but it is associated with some negative conditions, which are as follows:
- Rectal prolapse out.
- Bleeding.
- Appearance of puffiness.
- Seam separation.
If we compare Longo's operation with the classical method, the first one is the most gentle. During surgery, only a small area of the mucous membrane in the rectum is resected. In this case, the hemorrhoids are not excised, they are, relatively speaking, pulled up a little and fixed at some distance from the anus.
After the operation of hemorrhoidectomy according to the Longo method, instead of sutures, special staples are applied to the damaged areas of the mucous membrane. An additional plus of this method of removing hemorrhoids isno need for general anesthesia for the patient. However, there is a drawback to such an operation. It consists in the inability to eliminate externally located nodes. For this reason, the circle of its direct use is narrowing.
Preparation for the operation
Before proceeding with the surgical intervention, the specialist advises the patient to undergo some examinations to reveal hidden infectious and inflammatory processes in the body and possible pathologies of the internal organs.
For this purpose, the patient is prescribed an ultrasound scan, as well as a laboratory study of urine and blood. In addition, it is mandatory to perform a digital examination of the patient's rectum, as well as perform anoscopy.
What else needs to be done before a hemorrhoidectomy? Diet is also important in preparation for surgery. Experts advise not to eat foods that provoke gas formation, as well as the formation of fecal masses in excess before surgery. Preference should be given to easily digestible products: fermented milk products, eggs, semolina.
In parallel with this, the preparation of the patient on the eve and on the day of surgical intervention to remove hemorrhoids implies the following points:
- The patient's last meal should be 12 hours before surgery. You can't eat anything later.
- Before the operation, the patient should take a bath or shower and wear clean underwear.underwear.
- On the eve of surgery, it is imperative to carry out a cleansing enema, which is often replaced by the use of laxative medications Fortrans or Microlax.
Morgan technique
The essence of this surgical intervention is the excision of varicose external and internal hemorrhoidal veins. But before that, the vascular legs of the node are pre-sutured.
At the preparatory stage, the patient should lie down on the couch. Specialists fix his legs with the help of special supports. Abroad, this operation according to the Morgan method is performed with the patient lying on his stomach. At the same time, the patient's pelvis rises slightly, due to which there is an outflow of venous blood.
Hemorrhoidectomy is performed, as mentioned earlier, under general anesthesia. In addition, it is carried out according to a certain algorithm:
- The anal sphincter expands.
- The anoscope is inserted to gain access to the pathological area.
- The bump is grabbed and pulled out.
- The leg of the knot is clamped.
- The vessel is sutured and ligated with the varicose area.
- The node is being deleted.
Hemorrhoidectomy using a laser
This method is one of the minimally invasive types of surgery. Excision of the hemorrhoid with a laser is very effective. During this procedure, localanesthesia. The undeniable advantage of this method is the speed of manipulation, as well as low pain. After a few hours after the end of the procedure, the patient can already go home.
Laser coagulation of hemorrhoids involves following several steps:
- Divulsion of the rectum is done.
- Anoscope is inserted.
- After that, the localization of the pathological area is determined.
- Layer burning of hemorrhoids is done.
Post-operative period
What can be said about the postoperative period of hemorrhoidectomy? The recovery of the patient after such a surgical intervention is carried out quite safely. However, reviews of hemorrhoidectomy by patients indicate that they experience significant inconvenience, for example, the process of emptying the intestines is noticeably difficult. Many patients report experiencing soreness during this activity.
On the first day after surgery, you must completely abandon the use of products, but at the same time maintain the correct drinking regimen. On the second day after hemorrhoidectomy, specialists allow patients to eat light soups, cereals and sour-milk products.
To speed up the process of regeneration of postoperative wounds, they are treated with special ointments, which are made on the basis of methyluracil. As a rule, the patient remains in the hospital for 10 days. However, in reviews of hemorrhoidectomy, patients reportthat the rehabilitation period lasts for approximately 2 weeks.
To consolidate the therapeutic effect and prevent recurrence of the disease, the risk of which still remains with any type of therapy, patients are advised to adhere to the following simple rules:
- Do not sit for long periods of time.
- Avoid any physical activity that involves tension in the abdominal muscles.
- Do not lift weights.
- Eat right.
- Be active.
Possible Complications
Like any other operation, this procedure is dangerous for the development of various postoperative syndromes. If the patient has been shown hemorrhoidectomy, he should first familiarize himself with the possible complications after surgery. Patients' comments indicate that bleeding often occurs due to poor hemostasis or due to the falling off of the crusts of all vessels after burning. Other adverse effects of the operation include:
- Formation of anal fissures.
- Problems with bowel movements and urination.
- Fistula.
- Hemorrhoid recurrence.
- Narrowing of the anal passage.
- Various infections.
- Prolapse of the rectum.
Puffiness
This kind of complication after surgery can be observed for a variety of reasons. Perianal swelling afterhemorrhoidectomy is often the result of preoperative fusion of varicose veins. In addition, these adverse effects can also act as an individual reaction of the human body to radical therapy. Regardless of the exact reason for the formation of edema, subject to all the requirements of the specialists, the edema should go away on its own in a few weeks after the intervention.
Operation cost
As for the cost of surgical intervention, it will depend on the degree of neglect of the disease, as well as on the status of a particular medical institution. The cost of the operation in different regions of the country also differs. In private clinics, it is a priori higher, which can be explained by the use of good modern expensive equipment. However, do not forget that hemorrhoids can be cured for free if you seek help from a public medical institution. True, in this case, the patient will need to wait in line for the operation to be performed. Patient feedback says it takes a very long time.
For example, in a Moscow clinic, a Milligan hemorrhoidectomy can be done, on average, for 20,000 rubles. The closed type of operation is carried out at approximately the same cost. As for laser removal of hemorrhoids, the cost of such a procedure is about 30,000 rubles.
The most expensive operation is Longo's hemorrhoidectomy. For holding ityou will have to pay about 50,000 rubles in Moscow. As for other regions of Russia, as a rule, the cost for this procedure is an order of magnitude lower.
Patient testimonials
Consider what patients who have already experienced the treatment of hemorrhoids with hemorrhoidectomy write in the reviews. Most of them report that Milligan hemorrhoidectomy was used to treat this disease. The rehabilitation period after surgery is not so long, but not fast either. It usually takes about three weeks for a full recovery. However, the result is worth it.
A few write about side effects in the form of bleeding from the anus, fistula formation and prolapse of the rectum. Basically, those who have undergone surgery have problems with defecation (in the first days after surgery), but when the mucous membranes heal, everything returns to normal.
Patients who underwent Ferguson hemorrhoidectomy for the treatment of hemorrhoids note that wounds on the rectum heal much faster. However, not all clinics offer this type of surgery, which is inconvenient.
As for the choice of clinic, most patients with hemorrhoids choose private medical institutions for the operation. As a rule, in such clinics, hemorrhoidectomy is performed more accurately, and the conditions for the recovery of patients are quite acceptable.
We have considered what it is - hemorrhoidectomy. Before the operation, the patient must undergoexamination, as well as familiarize yourself with possible contraindications.
