Hemorrhoidectomy – the golden standard of hemorrhoids treatment of the 4th stage, and also at a clottage of the dropped out hemorrhoidal units. Hemorrhoidectomy is also done to patients with hemorrhoids of 3d stage with a greater hemorrhoidal units.
At this intervention the site of a peri-anal skin and the mucous rectum is selected, located above hemorrhoidal unit which is ligated and crossed. Subsequently there is a bracing of a mucosa of a rectum to a subject tissues. The intervention is carried out within one day. The results are very good, relapses of disease are observed seldomly.
Besides a traditional scalpel hemorrhoidectomy can be carried out with the use of an electro-coagulation and the laser. For the prevention of a stenosis of the anal channel and conservation of sensitivity between the wounds formed at excision of hemorrhoidal units, leave dermo-mucous intersections. These wounds can be taken in (closed hemorrhoidectomy) or to leave opened (opened hemorrhoidectomy). The choice of a technique depends on preferences of the surgeon.
In order to prevent pain and an ischuria (the most frequent complications after hemorrhoidectomy) it is not necessary to pad the proctal channel. Patients are recommended to limit the liquid reception. To decrease of a pain in the early postoperative period, 0,2 % nitroglycerinum cream is applied, eliminating a spastic stricture of a rectum sphincter.
Also analgetics and sedentary baths are appointed . If the emiction was restored, plentiful drink and the laxatives enlarging volume of intestinal contents are recommended. It normalizes defication and warns constipation. Manual research of a rectum is being done in 1 or 3 weeks after the operation for exception of a stenosis of the proctal channel.