环状痔脱出伴直肠黏膜内脱垂的外科治疗

Surgical treatment of circuiar hemorrhoids prolapse combined with internal rectal prolapse

目的 :采用肛垫部分切除加直肠黏膜纵行缝合术治疗环状痔脱出伴直肠黏膜内脱垂。方法 :于痔右前、右后、及左侧环状母痔处将松弛的黏膜即肛垫部分切除 ,同时将在切除肛垫处痔上缘齿线上 1cm处纵行缝合直肠黏膜 5cm以上 ,使组织缩短悬吊内脱垂的黏膜及痔 ,以取代松弛断裂的Trietz肌。结果 :本组患者术后痔脱出症状减轻甚至消失 ,同时直肠黏膜内脱垂引起的便秘症状明显改善。结论 :脱垂痔与直肠黏膜内脱垂往往同时存在 ,处理痔的同时一并处理内脱垂的直肠黏膜引起的便秘症状 。

Objective:To evaluate effects of partially anal cushion resection and longitudinl rectal mucosa suture on circular hemorrhoids prolapse accompanied with intemal rectal prolapse.Methods:The prolapsing hemorrhoids at the left lateral,right anterior,and right posterior quadrants,also named anal cushion,was resected partially.Meanwhile,we sutured the mucosa lengthways 1 cm above the dental line at least 5 cm as a substitution of the ruptured Trietz muscle in order to shorten the tissue and suspend the prolapsing hemorrhoids and improve the internal rectal prolapse.Results:17 patients underwent this procedure.The symptoms of hemorrhoids prolapse and constipation attribute to the internal rectal prolapse were alleviated or even disappeared postoperatively.So the success rate was 100 percent.Conclusion:Prolapsing hemorrhoids was always companied with internal rectal prolapse.Therefore,the constipation symptoms should be simultaneously considered whenever the prolapsed hemorrhoids were resolved.This procedure is safe,simple and effective to deal with the vicious circle:hemorrhiods--constipation--severe hemorrhoidal disease.