Microscopic Anatomy Of The Anal Cushion And Clinical Study Of TST Combined With Anal Cushion Plasty And Exfoliation Ligation

Objective To observe the curative effect of two kinds of operation on mixed hemorrhoids patients who underwent selective hemorrhoidectomy combined with reserved anal cushion plastic surgery(TST combined with reserved anal cushion plastic surgery)or external stripping and internal ligation.Methods The patients with mixed hemorrhoids who underwent surgical treatment in our hospital for a period of time were selected for study,the treatment group and the control group had 50 cases in each group.The treatment group was treated with TST combined with reserved anal cushion plastic surgery,while the control group was treated with external stripping and internal ligation.The clinical cure rate,intraoperative blood loss,operation time,hospitalization time,hospitalization expenses,wound healing time and other complications were observed and compared between the two groups.Results 1.Anal cushion is composed of anal cushion mucosa,blood vessels,Treitz muscle and loose connective tissue.It is located about 1.5 cm above dentate line and lip-mounted circular thickening normal tissue at the lower end of rectum.2.HE staining showed: In the submucosa of anal cushion and hemorrhoid tissue,there are many dilated and thin-walled blood vessels,tissue edema or fibrous tissue proliferation,Ttreiz muscle rupture,monocyte-macrophage increase and blood clot formation.3.There was no significant difference in clinical cure rate,urinary retention and anal distension between the two groups(P > 0.05).It showed that the new operation had the same characteristics as exfoliation and internal ligation,such as reliable curative effect,low recurrence rate and simple operation.4.Compared with exfoliation and internal ligation,the new operation reduced operation time,hospitalization time,wound healing time,intraoperative bleeding volume,post-operative pain and anal stenosis(P < 0.05),suggesting that the new operation did not increase the risk and adverse reactions of the operation,and was safe and reliable.5.but the hospitalization expenses in the control group were lower than those in the treatment group(P < 0.05).Conclusion On the basis of guaranteeing clinical cure rate,TST combined with reserving anal pad plastic surgery can preserve the structure of anal pad as far as possible and reduce tissue damage,thus reducing the complications such as operation time,hospitalization time,wound healing time,intraoperative bleeding volume,postoperative pain and so on.It is an effective method for treating mixed hemorrhoids,which is worthy of clinical popularization and application.