Our Summary

This research paper is about a study that was conducted to find out how to prevent a condition called rectal stricture (a narrowing of the rectum) after a surgery for prolapse and hemorrhoids (a common type of surgery for hemorrhoids).

The researchers divided 400 patients who had severe mixed hemorrhoids into four groups of 100. The first group had a special procedure during surgery and had their anus widened afterwards. The second group had the special procedure during surgery, the third group had their anus widened after surgery, and the fourth group only had the standard surgery.

They observed these patients for 1-2 months after their surgeries and then checked in on them for up to 3 years. The treatment was effective for all patients in terms of treating their hemorrhoids.

However, they found that none of the patients in the first group developed rectal stricture, while 11%, 7%, and 14% of the patients in the second, third, and fourth groups respectively did.

So, the conclusion is that having the special procedure during surgery and widening the anus afterwards can prevent rectal stricture. Furthermore, it strengthens the surgical connection and reduces bleeding. The procedures are simple and can be easily used more broadly.

FAQs

  1. What is the purpose of the study on rectal prolapse surgery?
  2. How effective is the thread-drawing and anal enlargement technique in preventing postoperative rectal stenosis?
  3. What were the rates of rectal stenosis in the different groups studied?

Doctor’s Tip

A helpful tip a doctor might tell a patient about rectal prolapse surgery is to follow post-operative care instructions carefully, including avoiding heavy lifting or strenuous activities, eating a high-fiber diet to prevent constipation, and keeping the surgical area clean to reduce the risk of infection. It is also important to attend all follow-up appointments with your healthcare provider to monitor your recovery progress and address any concerns or complications promptly.

Suitable For

Patients with severe mixed hemorrhoids who are at risk for rectal stenosis after undergoing a procedure for prolapse and hemorrhoids (PPH) may be recommended rectal prolapse surgery. Additionally, patients who have not had success with conservative treatments for rectal prolapse may also be recommended for surgery. Patients who experience symptoms such as chronic constipation, rectal bleeding, or difficulty controlling bowel movements may also be candidates for rectal prolapse surgery. It is important for patients to consult with a healthcare provider to determine if rectal prolapse surgery is the best treatment option for their individual situation.

Timeline

Before rectal prolapse surgery:

  1. Patient experiences symptoms of rectal prolapse such as rectal bleeding, discomfort, and a feeling of a bulge or protrusion from the anus.
  2. Patient consults with a doctor or colorectal surgeon to discuss treatment options.
  3. Doctor performs a physical examination and may recommend diagnostic tests such as a colonoscopy or imaging studies to confirm the diagnosis.
  4. Patient and doctor discuss the risks and benefits of surgical treatment for rectal prolapse.
  5. Patient undergoes pre-operative preparations such as fasting, bowel preparation, and possibly stopping certain medications.

After rectal prolapse surgery:

  1. Patient undergoes the surgical procedure for rectal prolapse, which may involve different techniques such as perineal rectosigmoidectomy or laparoscopic rectopexy.
  2. Patient is monitored in the hospital for a period of time post-surgery to ensure proper healing and recovery.
  3. Patient may experience some pain, discomfort, and swelling in the anal area post-surgery.
  4. Patient is given post-operative instructions on wound care, diet, activity restrictions, and medication management.
  5. Patient follows up with the doctor for post-operative visits to monitor healing and address any concerns or complications.
  6. Patient gradually resumes normal activities and may need to make lifestyle changes to prevent recurrence of rectal prolapse.

What to Ask Your Doctor

  1. What is the success rate of rectal prolapse surgery?
  2. What are the potential risks and complications associated with this surgery?
  3. How long is the recovery process and what can I expect during the post-operative period?
  4. Will I need to make any lifestyle changes or follow a specific diet after the surgery?
  5. Are there any alternative treatment options available for rectal prolapse?
  6. How will you monitor my progress after the surgery?
  7. What are the chances of developing rectal stricture after the procedure and what measures can be taken to prevent it?
  8. How experienced are you in performing rectal prolapse surgery?
  9. Are there any specific instructions or precautions I should follow before and after the surgery?
  10. Can you provide me with more information about the specific techniques or procedures you will be using during the surgery?

Reference

Authors: Wei D, Jiang P, Gao R, Zhao Y. Journal: Am Surg. 2023 Dec;89(12):5932-5939. doi: 10.1177/00031348231180925. Epub 2023 May 31. PMID: 37257493