Our specialist will tell you about how to properly make up for the removal of hemorrhoids and what is the importance of a balanced diet in the recovery period.

The general rules include the following recommendations.

1. Dividing the volume of food into 6 meals a day.
2. Attention should be focused on nutritious and healthy foods rich in vitamins.
3. Elimination of cold or hot food that irritates the mucous membranes.
4. Tracking stool that should be soft.
5. Elimination of gassing products from the diet.
6. Meals should be at the same time every day.
7. Strictly control your drinking regime.
8. Prefer cooked or steamed food.

The first day after hemorrhoidectomy will be the most difficult. During this period, a starvation diet is indicated to avoid bowel movements. Pure water must be consumed a lot.

On the second day, oatmeal in water and vegetable decoctions are allowed. It is worth introducing a pre-developed dietary menu after the healing of wounds. Food should not cause hysterical bowel movements. A strict diet is shown only in the first month, then indulgences are allowed, in reasonable measures.

As for the diet, it may contain the following foods:

• grated cottage cheese and low-fat kefir;
• lean meat;
• semi-liquid oatmeal or buckwheat porridge on the water;
• vegetable broth soups.

After a week, you can add baked apples and stewed vegetables to your diet. By the end of the operating period, the diet can be made more free, but continue to adhere to the following restrictions.

• exclude alcohol, coffee, chocolate, fried foods and smoked meats;
• replace sugar with fruit and honey;
• fermented milk products on a daily basis;
• exclusion or limitation of flour products;
• preference for non-fried and lean meat, vegetables;
• frequent small meals.

For the prevention of pathology, diet alone is not enough.

To keep the intestines in good shape, it is imperative to exercise, and include foods rich in fiber in the diet.

Use of medications

The use of laxatives is allowed. Among the safe ones, Normase and Duphalac are worth highlighting. Make daily baths with the addition of potassium permanganate or chamomile decoction.

Rectal suppositories Natalsid will help stop rectal bleeding, and suppositories with papaverine, Anestezin, candles with belladonna, Anusol or Relief Advance will help to cope with pain syndrome. Levomekol ointment and methyluracil suppositories promote wound healing.

Local use of an ice-cold water bottle or injections with analgesics is only allowed for very severe pain.

Possible complications

On the one hand, the operation itself and the management of the patient after it are so worked out by modern doctors that the likelihood of complications is minimized. However, this possibility still exists.

Common complications after any such surgery include:

• sepsis;
• thrombosis of veins in the legs;
• bleeding;
• allergic reactions.

Specifically, after hemorrhoidectomy, the following problems may arise:

• narrowing of the anal canal;
• fecal incontinence or constipation;
• problems urinating;
• pain during bowel movements;
• relapse of the underlying disease.

How to avoid relapse?

Despite the fact that this surgical intervention eliminates the problem completely, the patient still must take measures to avoid relapse. Important rules:

• enhanced drinking regime;
• strict adherence to dietary recommendations;
• taking laxatives and dietary fiber, according to the prescription of the attending physician, if there is a predisposition to constipation;
• the urge to defecate cannot be ignored;
• maintaining a healthy weight;
• moderate physical activity.

In conclusion, it should be added that most often the operation in question is prescribed if the hemorrhoids are very neglected. Therefore, you should not wait until the situation deteriorates so much that, apart from radical measures, there will be no other ways to combat the disease.

Hemorrhoids occupy a leading position in surgical pathology. Late primary appeal to medical institutions is characteristic, when the process is already running, overgrown with complications and requires radical removal of hemorrhoids.

Operation hemorrhoidectomy is one of the first methods of surgical treatment of hemorrhoids, which does not lose its relevance to this day.

In some stages of the disease, when medications and minimally invasive interventions are ineffective, only hemorrhoidectomy is indicated. What is this method? The essence of the operation is to completely cut off the varicose veins of the rectum. With other radical methods, hemorrhoids undergo infrared coagulation, cryodestruction, ligation of varicose veins or adducting arteries, hardening of blood vessels or stretching of the mucous membrane, followed by its suturing. In comparison with the listed methods of invasive therapy, radical excision of varicose veins of the rectum is often accompanied by postoperative complications.

Hemorrhoids are leaders in surgical pathology

Indications for the removal of nodes

Hemorrhoidectomy is the main treatment for the following conditions:

• stage IV hemorrhoids;
• bleeding from the cavernous veins, accompanied by anemia;
• frequent exacerbations that cannot be treated with conservative treatment;
• stationary loss of nodes;
• thrombosis of hemorrhoidal veins at any stage of the disease;
• hemorrhoids stage III with a pronounced increase in cones.

There are four stages of hemorrhoids

The essence of surgical treatment

Methods of hemorrhoidectomy are reduced to a longitudinal dissection of the mucous membrane with partial capture of the skin and radical removal of the nodes. The cones are excised together with the vascular pedicle. With a sharp increase or close location, when the leg is technically impossible to remove, in order to avoid postoperative complications, it is coagulated and left.

General anesthesia (general anesthesia) or epidural anesthesia is preferred. Local chipping of the operating field for hemorrhoids is not used due to tissue impregnation with distortion of the shape and size of the removed structures. Half an hour before the start of the operation, premedication is given to calm and relax the patient.

Open hemorrhoidectomy is a method in which mucocutaneous bridges are not sutured: the postoperative wound remains open. Healing time depends on the patient's age, comorbidity, method of intervention and the conscientiousness of following the doctor's recommendations in the postoperative period. Control finger examination after surgical excision of hemorrhoids is prescribed in 1-1.5 weeks.

Open hemorrhoidectomy in the treatment of hemorrhoids

Open hemorrhoidectomy is indicated for:

• internal hemorrhoids II degree with a sharp increase in nodes;
• combined hemorrhoids with stationary prolapse of cones;
• the recommended age of patients is over 40 years.

Closed hemorrhoidectomy is a method that is carried out in a similar way, only postoperative incisions of the mucous membrane are tightly sutured with interrupted sutures. The closed method of removing hemorrhoids has several advantages: reduced risk of infection, faster and less painful healing. Closed hemorrhoidectomy is the method of choice for stage III and IV hemorrhoids with a significant increase in cones or their habitual loss. Postoperative complications with the closed method of hemorrhoidectomy develop less frequently, are less intense and are quickly eliminated.

Absorbable and non-absorbable sutures are used as suture material for the closed method of removing nodes. The first ones do not require removal, except that long-term absorbable sutures can bring a feeling of discomfort, then they must be removed. The suture using non-absorbable sutures is subjected to periodic aseptic processing and removed 5-7 days after the operation.

The classic position of the patient on the operating table is on the back or on the stomach with bent legs.

Closed hemorrhoidectomy for hemorrhoids

Contraindications

Like any other operation, the method of surgical removal of hemorrhoids has several contraindications:

• severe cardiovascular failure, acute and chronic;
• decompensated liver and kidney diseases;
• malignant processes of any localization, including leukemia;
• acute or severe chronic infectious diseases;
• type I or II diabetes mellitus complicated by renal failure;
• organic lesions of the brain substance;
• epilepsy;
• pregnancy.

After the surgical method of removing hemorrhoids, tamponing of the anal canal is not performed. The first days of the postoperative period proceed with such consequences as pain after surgical removal of nodes, spotting, especially if the wound is not sutured. Short-term urinary retention may develop. In such cases, the patient's drinking regimen is reduced and pain relievers are prescribed.

Operation is prohibited during pregnancy

Complications of surgical removal of nodes

Complications after hemorrhoidectomy by open and closed method are possible:

• inflammation in the postoperative period with the attachment of pathogenic microflora;
• bleeding with or without a hematoma (blood after surgery is a logical and frequent complication);
• inconsistency of seams with a closed method;
• edema after hemorrhoidectomy always develops, causes compression of nerve endings and causes pain;
• retention or urinary incontinence;

Urinary incontinence is one of the complications after surgery

• narrowing of the sphincter and scars of the anal canal as a result of girregenerative processes;
• prolapse of the rectum when nerve fibers are damaged;
• fecal incontinence due to sensitivity disorders;
• the formation of an anal fissure after prolonged healing, the development of paraproctitis or fistula;
• a relapse of the disease is possible with varicose enlargement of other cavernous veins, bumps after the surgical method of removal may appear in the previously unchanged wall of the rectum;
• complications associated with anesthesia or anesthesia (allergic reaction).

Rectal prolapse is possible after surgery

Mandatory examination

Given the invasiveness of the method, the patient must undergo a comprehensive examination before the operation to remove the hemorrhoids. Donate blood for general analysis, biochemistry and coagulogram, determine its group and Rh factor, conduct an accelerated reaction to syphilis. Undergo fluorography and electrocardiography. Pass urine for a general analysis. If necessary, an allergic test for anesthetic is carried out in order to avoid anaphylactic complications. Each patient undergoes such an examination before any operation.

General blood analysis

Preoperative preparation

To reduce the risk of developing intra- and postoperative complications, regardless of the method of intervention, the patient undergoes preoperative preparation:

• The first point is to follow a low-protein diet, rich in fiber, the use of fermented milk products, mild laxatives. Surgical intervention does not exclude the use of drug therapy and local procedures with medicinal herbs.
• Mucous discharge in hemorrhoids leads to inflammation and maceration of the skin of the perianal region, which must be removed before surgery. In the presence of concomitant pathology - to achieve stabilization of the main indicators of cardiac and pulmonary activity, blood coagulation, to stop exacerbations.
• In the evening and in the morning before any method of operation, the patient is given a cleansing enema. On the day of surgery to remove hemorrhoids, it is not allowed to eat or any beverages due to the high risk of aspiration of vomit into the respiratory tract.

After premedication, the patient is sent to the operating room. Removal of nodes lasts an average of 30-40 minutes, the duration depends on the volume and method of intervention, the development of intraoperative complications. The patient spends the early postoperative period in a hospital, and in case of an uncomplicated course, he is discharged for outpatient treatment after 4–5 days.

Late postoperative period

Rehabilitation after surgical excision of hemorrhoids does not depend on the method of intervention and the type of suture material. Includes adherence to diet, avoidance of constipation, restriction in physical activity, treatment of the surgical field.

Nutrition after discharge from the hospital continues according to the same principles as in the early postoperative period:

• The main goal is to achieve an easy bowel movement that does not cause pain. The method of heat treatment of products plays an important role. For a patient after hemorrhoidectomy, boiled lean meat, vegetable protein with a large amount of fiber, boiled or steamed fish are recommended. Raw vegetables and fruits, dairy products (except cottage cheese), whole grain pasta and cereals. Eating light-carbohydrate foods, as well as fried, spicy and very hot foods is prohibited.
• The patient's drinking regime should be abundant. Method for calculating the rate of fluid intake: 30 ml per kilogram of body weight. The water balance should be replenished with pure water and herbal teas (preferably with a mild laxative effect). Coffee and tea should be consumed in limited quantities, they absorb water and contribute to the development of edema. Carbonated drinks and alcohol are contraindicated.

The patient's drinking regimen should be abundant.

If diuresis has not recovered, fluid intake is limited. In case of prolonged (more than 3 days) urinary disturbance, you should consult a doctor. Recovery after surgery in elderly and senile patients is slower than in young patients.

Pain after surgery bothers the patient with any method of invasive treatment. To relieve pain, non-steroidal analgesics are used, which also have anti-inflammatory and antipyretic effects. Ointments and creams with anesthesin are applied topically.

Healing after the open method is longer and depends on the regenerative abilities of the body. In the absence of complications, it lasts 4–5 weeks, with the closed method - up to a month. To stimulate reserve cells and activate fibroblasts, they use sedentary baths with medicinal herbs (nettle, chamomile, knotweed). With scrupulous implementation of the recommendations of a specialist in the postoperative period, the wound heals without early and long-term complications.

To eliminate spasm of the external sphincter of the rectum after removal of hemorrhoids, a nitroglycerin cream is prescribed. Cramping during bowel movements in the postoperative period causes pain and can cause complications such as anal fissure. Even small tears in the mucous membrane are indicated by blood after bowel movements on toilet paper or in faeces.

Solcoseryl ointment for hemorrhoids

Mandatory toilet of the perianal area with the use of medicinal plants and the subsequent use of painkillers, anti-inflammatory and regenerating drugs. In the first few days, it is advisable not to use paper, it is better to wash off with clean water or herbal decoctions.

To reduce the load on the anal canal after surgery, it is necessary to reduce physical activity. During the month, do not lift weights, do not engage in active sports. The first 4–5 days after removal of hemorrhoids, bed rest is recommended. After 10-14 days, you can start walking for 30 minutes. In the following, yoga classes, light jogging, swimming in the pool are shown.

In the event of complications after any method of surgical treatment (blood after bowel movements, discharge of the stitches that remained after removal, mucus and purulent impurities in the feces, fever), the patient should consult a doctor. The sooner the correction is carried out, the greater the chances of recovery. Reoperation is possible.

Early appeal when the first symptoms of hemorrhoids appear guarantees a 100% treatment effect. In advanced stages, a radical operation is indicated. If it was not possible to avoid surgical removal of nodes, diet after hemorrhoidectomy, adherence to all the recommendations of the proctologist and moderate physical activity are the key to persistent clinical and anatomical postoperative remission.

In connection with modern trends towards an inactive lifestyle and the abuse of bad habits, hemorrhoids are becoming an increasingly common disease. It affects both men and women. Shyness and awkwardness make patients delay the visit to the doctor. Not surprisingly, this results in complications that can only be resolved with surgery. In this article we will look at what hemorrhoidectomy is, in which cases it is prescribed, how the operation is performed.

Surgical removal of hemorrhoids

Hemorrhoids are caused by blood clots in the veins. They turn into knots that are easily injured, cause pain and bleeding.

Surgical intervention is already considered the most extreme method of treatment. Most often, patients are prescribed a special diet, ointment or suppositories. If they do not help, and the person's condition is rapidly deteriorating, then you have to turn to surgeons.

There are such surgical methods for removing hemorrhoids:

• hemorrhoidectomy;
• latex ligation of hemorrhoids;
• dearterization (blockage of an artery);
• sclerosing of hemorrhoids;
• coagulation of hemorrhoids (laser treatment).

It is the surgical removal of hemorrhoids that is most effective and prevents the formation of new nodes.

Hemorrhoidectomy is the most popular operation in a specialized proctological hospital

Indications for the removal of nodes

It is necessary to immediately seek surgical help if a person has hemorrhoids accompanied by the following symptoms:

• frequent bleeding that causes anemia;
• pronounced inflammation;
• constant loss of large nodes;
• high temperature;
• severe pain.

The operation can affect the future life of the patient, therefore, surgical excision of hemorrhoids is resorted to only when other methods of treatment do not help.

Hemorrhoidectomy - what is it?

Hemorrhoidectomy has been popular since 1935. It was then that two surgeons first tried the surgical method of treating hemorrhoids.

Read also

Treatment of hemorrhoids in the early stages

There are several types of hemorrhoidectomy:

1. Open hemorrhoidectomy (according to Milligan-Morgan). After such removal, wounds are left to heal naturally. The patient must be constantly under the supervision of a doctor.
2. Closed hemorrhoidectomy (according to Ferguson). After removal of the nodes, the wounds are sutured, healing after hemorrhoidectomy is faster and easier.
3. Submucous. Only the damaged tissue under the mucosa is removed and sutured.

The proctologist surgeon evaluates the feasibility of using the operation in any particular case

Contraindications

• Crohn's disease;
• pregnancy;
• inflammation in the intestines;
• cold;
• oncological diseases;
• problems with blood clotting;
• immunodeficiency.

Also, it is not recommended to carry out the operation for the elderly with weak immunity and heart problems. If the blood does not flow much and does not cause anemia, then it is better to continue to treat the patient with pills and topical medications and follow a special diet.

Complications after hemorrhoidectomy

As with any surgical procedure, the patient may experience complications:

• fecal incontinence;
• the risk of catching an infection;
• delayed feces;
• intestinal prolapse;
• narrowing of the anus;
• relapse;
• rectal fistula.

The occurrence of complications after hemorrhoidectomy partly depends on the competence and experience of the surgeon performing the operation.

Keep in mind that all of the above complications can only arise if doctors are incompetent or outdated equipment. If you take a responsible attitude to the choice of the clinic and the surgeon who will perform the operation, then the negative consequences after hemorrhoidectomy can be avoided.

Preparing for surgery

First of all, a patient with hemorrhoids needs to undergo a medical examination, including the following types of diagnostics:

• Ultrasound, TR (transrectal) ultrasound;
• blood and urine tests.

This can help identify conditions that may interfere with the normal operation and recovery from hemorrhoidectomy.

It is also necessary to cure all inflammation in the intestines in a conservative way so that excess mucus is not secreted from the intestines.

Since the operation is performed in the area of ​​the intestine, it is important to normalize its work before the operation. This is best done with a special diet. As a last resort, you can use a laxative.

Read also

Microlax for hemorrhoids

How is hemorrhoidectomy performed?

The operation itself is often performed under general anesthesia, but local anesthesia is sometimes used as well. It takes no more than 30 minutes.

Hemorrhoidectomy is performed in several stages

Hemorrhoidectomy is performed as follows:

1. The patient lies on his back with fixed limbs or on his stomach with a raised pelvis. This improves venous return.
2. The incision site is prepared for surgery. If there is hair, they shave it off, and the anus is disinfected and treated with disinfectants.
3. The doctor dilates the anus and inserts an anoscope that has been pre-lubricated with glycerin. It is easier to perform the operation with it.
4. The hemorrhoid is pulled out with a special tool and stitched at the artery.
5. With the help of an electrocoagulator, bleeding is stopped if necessary.

Postoperative period

After hemorrhoidectomy, the patient is often left in the hospital for some time to monitor the reaction of his body. They prescribe a special diet that does not injure the intestines. Products should be very gently excreted from the body and not injure the anus. Fresh wounds should be regularly treated with ointments and warm medicated baths should be taken.

Expected Result

Thanks to hemorrhoidectomy, the following results can be achieved:

• completely remove the symptoms of hemorrhoids;
• prevent its re-formation;
• rid the patient of the nodes.

Hemorrhoidectomy minimizes the likelihood of recurrence.

Hemorrhoidectomy - what is it? Hemorrhoidectomy operation is radical removal of hypertrophied tissues based on ligation of the blood supplying nodes of the vessels.

For many years, this surgical intervention has served as a reliable method of getting rid of nodes, even in cases where other methods do not bring the desired result.

In specialized proctological clinics, this type of operation is still in first place in terms of frequency of spread. This is due to the fact that currently practiced minimally invasive techniques are not always effective and have so far been little studied.

Wherein the majority of surgeons - coloproctologists own the technique of hemorrhoidectomy operations... Experienced doctors are of the opinion that it is hemorrhoidectomy that guarantees getting rid of the manifestations of the disease for the longest possible period.

The hemorrhoidectomy technique was developed in 1937 and subsequently improved by many professional surgeons. Over the period of development of the operation technique, several of its varieties have appeared.

The original open type of operation was supplemented in 1959 with a closed hemorrhoidectomy, which allows it to be performed on an outpatient basis.

Hemorrhoidectomy is an operation aimed at completely removing existing hemorrhoids. Surgery is performed under local epidural anesthesia, in rare cases under general anesthesia.

The tissues are excised together with the perial skin above them. During the operation, the vessels are ligated, and the mucous tissues are fixed to the subject.

The total duration, depending on the structure of the patient's anal passage and the stage of the disease, is 20-60 minutes. During the operation, the patient is placed on his back with legs fixed on special supports.

Sometimes the patient is placed on his stomach and the pelvis is raised. In this position, the outflow of venous blood is improved.

The doctor conducts a devulsion (expansion) of the anus and inserts an anoscope into it lubricated with glycerin. Thus, access to the hemorrhoids is opened.

There is no universal method of excision of nodes, and in each specific case, the surgeon chooses a specific instrument or a combination of them. After excision, wounds are sutured or left open. The procedure is completed by placing a tampon and a gas outlet tube into the rectum.

Indications and contraindications for surgery

Before prescribing an operation, the attending physician assesses the benefits of the surgical intervention and the perceived risks of its implementation.

The operation should be abandoned under the following conditions:

• advanced age and reduced immunity of the patient;
• pregnancy;
• the presence of malignant tumors;
• inflammatory processes in the intestines;
• the presence of concomitant diseases (Crohn's disease, HIV, cirrhosis, heart and pulmonary failure).

Varieties of hemorrhoidectomy

Depending on the technique of the surgical intervention there are 5 types of hemorrhoidectomy:

• open;
• closed;
• stapling (Longo's method);
• Parks method;
• Internal harness (Subbotin method).

In the sections below, we will talk about each of the operations separately.

Open

Hemorrhoidectomy classic -. During the application of this technique, it has undergone changes.

The essence of open Morgan-Milligan hemorrhoidectomy is to use it to remove not only external, but internal nodes.

The peculiarity of the operation consists in the complete excision of the nodes and its removal along with the mucous membrane.

After the operation, the nodes remain open, and after that their natural healing occurs.

The method is traumatic, therefore, the operation is performed under general anesthesia in a hospital setting. You can learn more about the operation using the Morgan-Milligan method by watching the video below:

Closed

The author of the method is American doctor Ferguson. The operation is a modification of the classic hemorrhoidectomy.

A retractor is used to expose the tissue, which is then removed from the anus. After excision of the nodes, the wounds are sutured with self-absorbable sutures. It is important to follow a diet after hemorrhoidectomy to rule out complications and relapses.

Stapling (Longo method)

The method was developed in the 90s of the last century. Unlike the classic surgery in this case, the rectal mucosa and the vessels carrying blood to the nodes are intersected.

In Russia, operations using this technique began to be used only 5 years ago. Hemorrhoids falling out of the anus are clamped with a special stapler, excess mucosal areas are cut off.

The prolapse of the anal skin is reduced by the insertion of a dilator. An anoscope is inserted through it to control the application of a purse-string suture.

With the help of an anoscope, the fallen out mucous tissue is pushed into the anus. The anoscope is rotated 270 degrees and a suture is applied along its course.

The circular stapler is positioned next to the seam and the cover assembly is cut off. The thread is pulled outward, and a stapler is inserted into the anal canal. The seam is tightened, while the fallen out mucous membrane falls on the circular stapler, which heats up.

When heated, a second row of staples is applied. With a circular knife, excess tissue is cut through the top of the anus.

The advantages of the method are relative painlessness. The postoperative period after hemorrhoidectomy is much easier and faster than with classical surgery, so the average length of stay in the hospital is shorter.

In the same time there are certain risks and possible complications after hemorrhoidectomy:

• damage to rectal tissue;
• stretching of the internal muscles of the anus;
• pelvic sepsis;
• the method is not effective for large knots, as the tissue may not fit into the stapler;
• with such an operation, it is impossible to excise the veins that are located on the surface;
• due to insufficient experience in carrying out such operations, long-term consequences cannot be predicted.

The video below shows the process of surgery according to the Longo method:

Parks method

An operation in which only hemorrhoids are excised, the mucous membrane is not affected. This the most gentle operation, with little blood loss and no pain in the postoperative time.

Manipulations are performed with a laser or electrosurgical unit. During laser hemorrhoidectomy, the blood vessels are cauterized during the excision of the nodes, so the blood is practically not released.

Internal harness (Subbotin method)

Minimally invasive surgery performed under local anesthesia. A clamp and a scalpel are inserted into the anus.

The mucous membrane around the base of the knot is tied with a special ring. After a while, the bloodless knot dies off and falls out on its own.

Gallery

Below are photos of both before and after hemorrhoidectomy:

Preparing for surgery

Preoperative preparation is an important step in any surgical procedure.

Before hemorrhoidectomy, you need to prepare the rectum for the upcoming manipulations and to prevent bleeding and infection:

1. Undergo blood and urine tests.
2. Examine the rectum(anoscopy, sigmoidoscopy, finger examination).
3. A few days before the operation, exclude from the diet foods that stimulate increased gas production and the formation of solid feces (white bread, eggs, meat).
4. On the eve of the operation or.

IMPORTANT. In the case of taking blood thinning drugs, they are canceled two weeks before the operation.

Now that you have learned more about hemorrhoidectomy, the postoperative period is the next important topic that we will cover in this article.

Recovery period

After hemorrhoidectomy, it lasts from 4 to 6 weeks, depending on the type of surgery, the patient's age and the state of his body. Efficiency is restored after 3-4 weeks, but pain can persist much longer.

Therefore, in the first month after surgery, patients are prescribed to restore their general condition after hemorrhoidectomy.

When can you sit after hemorrhoidectomy? After removing the nodes, you can sit no earlier than on the fourth day.

If severe pain is felt, and there is bleeding after hemorrhoidectomy, it is better to wait another three to four days for the wounds to heal properly.

To reduce the load on the anus, special devices in the form of a donut are used designed for seating. In the first two weeks, you need to move as little as possible, exclude any physical activity.

The main problem in the postoperative period is severe pain. They are removed with nitroglycerin ointment.

To speed up the healing process after hemorrhoidectomy, apply or. Effectively, which accelerate tissue regeneration.

ATTENTION. On the first day after the operation, the release of stools from the rectum is unacceptable, therefore, food must be discarded.

An important point after surgery is. The anal opening should be thoroughly washed and treated with an antiseptic after defecation so that an inflammatory process does not develop when an infection enters the wounds.

Within 1-2 months after the operation, the patient will have to observe after hemorrhoidectomy:

Postoperative complications and their prevention

The most common complications are:

1. Retention of urine. The problem is solved by the introduction of a catheter on the first day after the operation.
2. Stool retention. Constipation after hemorrhoidectomy is rather a psychological problem associated with the fear of pain during bowel movements. In this case, a laxative is prescribed.
3. Development of fistulas and fissures in the anus. Occurs due to trauma by feces. Cracks are healed with nitroglycerin ointment. Fistulas require excision.
4. Bowel prolapse. This complication requires immediate surgical intervention, otherwise tissue necrosis may occur, which will lead to a complete loss of organ functions.
5. Narrowing of the anal opening. The problem is solved by the introduction of dilators or plastic surgery.
6. Fecal incontinence. It occurs due to a violation of the ligaments in the anus.

Recurrence of the disease

Hemorrhoidectomy is a radical way to remove nodes. Correctly performed operation eliminates the problem for a long time. Hemorrhoidal cones removed by surgery, in principle, cannot develop again.

But this does not mean that once having been cured of, a person will not meet with him again. In the presence of provoking factors, new nodes are formed in the rectum, and they will have to be removed again.

After hemorrhoidectomy, it is possible under the following conditions:

1. Violation of the diet: overeating, infrequent meals. Such a diet leads to indigestion, provokes constipation, therefore, the tension of the rectum increases during bowel movements.
2. Eating spicy and smoked foods, which promotes active blood flow to the pelvic organs.
3. Lifting weights.
4. Pregnancy.
5. Sitting for a long time.

Possible infections and inflammations

To avoid recurrence of hemorrhoids and to consolidate the results of the operation, you must adhere to the following recommendations:

1. Do not lift heavy objects.
2. Eliminate physical activity with tension in the press.
3. Try to spend less time sitting and standing. If you spend time sitting due to the nature of your activity, you need to get up and walk around as often as possible so that blood does not stagnate in the pelvic organs.
4. Exclude spicy dishes, marinades, smoked meats from the diet.
5. It is not recommended to drink alcohol not only after surgery, but in general in the presence of hemorrhoids.

   Alcohol decreases blood clotting and may contribute to bleeding. The decomposition products of alcohol have a toxic effect on the intestines, the mucous membrane of the rectum will inevitably suffer when it is removed from the body.

Conclusion

Hemorrhoidectomy is a way to say goodbye to painful nodes for a period of 6 to 12 years. If there are direct indications for its implementation, you should not delay and be afraid of meeting with the surgeon.

The correct approach to fixing the problem, a guarantee of a positive result.

Hemorrhoidectomy remains the most demanded surgical operation to remove hemorrhoids. Modern changes in the technique of performing the operation made it possible to make it less traumatic.

Igor Andreevich, Ufa: “Good morning, yesterday the surgeon recommended a hemorrhoidectomy to relieve me of hemorrhoids. I am now 50 years old, the disease has been plaguing me for seven years. I don't know anything about this method, ointments and suppositories no longer help. You can tell and give advice on this operation. Thank you!"

Among the many diseases, hemorrhoids are "famous" for their neglected forms. Although proctologists recommend getting an examination at the first alarming symptoms, for many people a sense of false shame prevents them from going to the doctor on time. As a result, the pathology turns into neglected forms, for the treatment of which surgical intervention is necessary.

Operative treatment

Several minimally invasive methods of hemorrhoid treatment have been developed. They are characterized by a relatively gentle effect on the hemorrhoids themselves and the surrounding tissues. Many do not require a long time for the procedure and subsequent recovery. True, the cost of such surgical treatment can be very high.

The general-purpose classical operation of hemorrhoidectomy remains in the service of surgeons. It has been used since the thirties of the last century, and is named after its developers - Milligan and Morgan.

Doctors prescribe such treatment for hemorrhoids to patients in whom the disease reaches the third and fourth stages. In such situations, conservative remedies are ineffective. Local medications can only provide relief, but do not solve the underlying problem.

Milligan-Morgan operation

What is hemorrhoidectomy surgery? Hemorrhoidal disease is a pathological overflow of blood to the cavernous cavities, which, together with the blood vessels, form hemorrhoids. To remove them, a radical surgical excision is required.

Of course, over the past three-quarters of a century, the original method has changed. Surgeons operate with more sophisticated instruments. Recently, even hardware techniques have been used in some clinics in Russia. In this case, the operation in essence remains a classic hemorrhoidectomy, but is faster and almost bloodless.

Execution technique

Today, there are three types of techniques for performing hemorrhoidectomy:

1. Open. After their legs are tied up, no stitches are applied.
2. Closed. It differs from the previous version by the imposition of sutures (their removal is not required).
3. Submucous. In fact, this is a plastic surgery of the anal canal, since the stumps of hemorrhoids are literally hidden in the submucosal layer, and the mucous membrane itself is restored.

Preparing for surgery

To begin with, the doctor prescribes diagnostic tests and carefully conducts a digital examination of the rectum.

If the operation has already been scheduled, it is necessary to cleanse the intestines.

Now this can be done not only with enemas, but also with the use of special laxatives. The doctor will tell you which ones to change. In addition, the hair around the anus must be removed. It is better to restrict food 48 hours before the surgical treatment. Give up fatty meats, salty and spicy foods, legumes and flour delicacies.

How is hemorrhoidectomy performed?

For the operation, the patient lies on his back in a chair similar to a gynecological one. The legs are placed on special supports. The anesthesiologist administers anesthesia, and the surgeon proceeds to the surgical treatment. After removal of hemorrhoids, stitches are applied, and the patient is taken to intensive care to awaken.

The duration of the operation depends on the stage of hemorrhoids, the condition of the nodes, as well as the type of method used.

Advantages and disadvantages

Which of the three types of Milligan-Morgan operation to prescribe to the patient, the doctor decides. The variant of the operation determines the stage and course of the disease, the presence and absence of complications (for example, anal fissures), the general condition of the patient. Each technique has pros and cons.

So, after an open hemorrhoidectomy, a certain time is required for wound healing. This prolongs the rehabilitation period, which is relatively painless. Closed surgery gives a clear pain syndrome, which requires the appointment of painkillers to the patient. Submucosal hemorrhoidectomy is difficult in itself and, moreover, is accompanied by more intense blood loss.

Are there complications? Yes, as with any operation. The most frequent are bleeding, disturbances in the outflow of urine, and occasionally the anal sphincter weakens. Quite often there is a psychological complication in which people are literally afraid of defecation.

However, in any case, the result is still more important. The Milligan-Morgan operation allows you to cope with hemorrhoids at the third and fourth stages, when minimally invasive methods are no longer effective. Approximately 60 - 70% of people do not subsequently experience relapses of the disease, only a correct lifestyle is needed.

The rehabilitation period after hemorrhoidectomy lasts on average from three weeks to one and a half months. The first two to three days are recognized as the most difficult, then the condition gradually eases.

In the early stages of rehabilitation, doctors usually prescribe analgesics to patients, as well as local wound-healing agents. If you are afraid of defecation, the use of laxatives is allowed. If possible, on the first day, only liquid is recommended, then - a semi-liquid, mashed diet and plenty of drink. This is necessary for the formation of an uncomplicated, soft stool.

During the entire rehabilitation period, it is recommended carefully. It is based on dietary products - meat, dairy, non-coarse vegetables. You will have to exclude any legumes, apples and citrus fruits, raspberries, gooseberries and grapes. All fatty foods (including milk), rye bread, and all kinds of soda are also banned. It is worth limiting sweets, completely abandoning them. Avoid the temptation of canned food, smoked delicacies, spicy dishes.

What is such a strict diet for? It is the right diet that allows you to almost completely avoid potential complications.

Contraindications

There are diseases and conditions in which hemorrhoidectomy is contraindicated:

• pregnancy (at any time);
• immunodeficiency;
• some chronic diseases;
• various inflammatory processes;
• Crohn's disease;
• oncology.

And what the patients say - reviews

Reviews after hemorrhoidectomy:

Natalia: “Hemorrhoids started after the birth of a child. They said it would pass by itself, but instead got the third stage. The doctor said that the Milligan-Morgan operation is the only option. I didn’t feel the operation itself, because they did general anesthesia. But then I felt everything at once. They kept me on injections, for which thanks to the doctors. I was very afraid to eat at first, and then go to the toilet, but everything went fine. I recovered in about six weeks. "

Gennady: “I work a lot, so I postponed the treatment of hemorrhoids for a long time. I brought myself to the fourth stage with complications (there was an anal fissure). We made the operation an open method. When the anesthesia was gone, only the analgesics were saving. For the next three weeks I couldn’t sit normally, then everything became normal. ”

Irina: “A good doctor is very important in this operation. It was scary to go, she agreed, because there was no other way to cure hemorrhoids. It turned out she was more afraid. Of course, there were many unpleasant sensations, but I did not feel any wild pain, as my acquaintances scared. It was hard for the first two days, then for about a month I very strictly monitored food and stool. For half a year now everything is perfect. "

Doctor's opinion

Alexander Petrov, surgeon:“Hemorrhoids is a chronic disease that affects many people around the world. When conservative methods of treatment do not allow the doctor to hope for a positive outcome, then the only way to solve the problem is surgery.

Surgical treatment of hemorrhoids is represented by different methods of surgical intervention. The main task of such methods is the excision of tricky bodies located in the submucosal layer. The most popular, according to proctologists, is the Milligan-Morgan hemorrhoidectomy. The operation involves excision of hemorrhoids, stitching and removal of the cavernous bodies of the submucous layer of the rectum.

The classic hemorrhoidectomy has one drawback. After the nodes are removed, wounds form on the wall of the anal canal, which can bleed and cause pain. In addition, an infection can get into superficial wounds, which is fraught with serious complications. In this regard, after excision of internal and external hemorrhoids, many surgeons perform partial suturing of the edges of the wounds, and their secondary tension is performed. "

In many cases, the Milligan-Morgan operation is the only available option for getting rid of hemorrhoids. Careful preliminary examination, preparation and the right attitude help to transfer this operation well. Allows you to safely survive the rehabilitation period and continue an active lifestyle.

THERE ARE CONTRAINDICATIONS
NECESSARY CONSULTATION OF THE ATTENDANT DOCTOR

The author of the article Egorov Alexey Alexandrovich, proctologist

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4 Comments

I have my fourth pregnancy. After the third birth - after 3 weeks, while breastfeeding the baby - I experienced all the "beauty" of hemorrhoids. Nothing could be treated, for 3 weeks I went with my husband and child to the day hospital (it was a good summer) for droppers, injections, a laser, drank pills, which, on the one hand, would somehow help, on the other hand, they would not harm the child. Throughout the fourth pregnancy I am afraid of repeating the scenario of "breastfeeding with hemorrhoids", so as soon as hemorrhoids appeared, it was at the 7th month. (despite all the precautions taken - not using toilet paper, regular stool, proper nutrition, exercise and not gaining excess weight) At the 7th month, I underwent an operation - removal of this section of the vein (in fact, it already looked like a tentacle of an octopus - she, of course, could not perform any function). 3 weeks after that it was just some kind of hell - there was constant pain, I was afraid to eat, walk, sit, poop - you just feel like a complete invalid. Very important at this moment! I ate oatmeal in water, boiled beets, fresh carrot salads, broth, vinaigrette. Regularly in the morning, I sprinkled AO with lidocaine, smeared with any fatty ointment, did an enema, when the darkness passed in the eyes from defication, washed everything with miramistin and smeared with agrosulfate. She stayed alive, everything healed. Before delivery 2 weeks - a crack appeared, healed it. Now I feel 2 knots are swollen. Variants of childbirth to do a cesarean or then again an operation to remove is possible! and which is better? both there and there - pain, risk, recovery period ... (

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