Complications of rectal surgery

If you suffer from a disease called rectal prolapse, you will experience symptoms such as difficulty and incomplete defecation, long intervals between bowel movements, a feeling of lower abdominal heaviness, and abdominal bloating, so many patients will choose surgery for treatment. Surgical treatment of rectal prolapse has a very good effect now, but some patients still have some sequelae after surgical treatment - constipation. What should we do in this situation?

Rectoceles is considered a common cause of outlet obstructive constipation. Due to birth trauma and loose perineal soft tissue, the pelvic floor rectovaginal diaphragm of women is weak. During defecation, the rectum bulges toward the vagina, causing the physiological curvature of the lower rectum to change, which can cause defecation problems. However, is there an inevitable connection between rectal prolapse and defecation disorders? Is surgery necessary? What can surgery achieve? The author makes a brief analysis based on his 26 years of experience in anorectal surgery.

The main symptoms of rectal prolapse are constipation, difficulty in defecation, and a feeling of residual stool after defecation. It can be diagnosed by combining digital examination and defecography. The surgical treatments for this disease in China are divided into transrectal surgical repair, transvaginal surgical repair, and transperineal surgical repair.

1. Indications for surgery are: ① typical clinical manifestations; ② typical X-ray manifestations on defecography; ③ long-term conservative treatment is ineffective, and the rectum protrudes 15-20 mm; ④ normal or slightly prolonged colon transit test function

, ⑤The electromyography examination of the puborectalis muscle was normal.

2. Surgical treatment methods can be divided into transrectal surgical repair, transvaginal surgical repair, and transperineal surgical repair. Transperineal surgery can reduce the postoperative infection rate because it does not pass through the rectum and vagina. However, this procedure cannot remove excess mucosa in the rectum or treat anal canal and rectal lesions. Therefore, in clinical practice, the appropriate surgical procedure should be selected according to the severity of the patient's condition and the presence of anorectal complications.

Rectocele, also known as rectocele, is a disease of posterior pelvic floor relaxation. The posterior pelvic floor refers to the part from the cervical ring to the perineal body, including the cardinal sacral ligament, vaginal apex structure, rectovaginal fascia, perineal body and external anal sphincter. The main clinical manifestation of rectal prolapse is outlet obstruction constipation, which has a high incidence rate. According to statistics, the incidence rate in middle-aged and elderly women is 75% to 81%, but some people do not have obvious clinical symptoms, so the exact incidence rate is not clear.

Prognosis

For some patients, proper use of medication can help them to have smooth bowel movements and relieve local symptoms. If the medication is not effective, surgical treatment may be considered, but care should be taken to prevent recurrence after surgery.

prevention

1. The tissue of the anterior wall of the male rectum is denser, while the recto-vaginal septum of females is weaker, which makes it easy for rectocele to form. Therefore, rectocele is a unique X-ray sign of female outlet obstruction. The treatment is mainly to clear the discharge tract, that is, to solve the problems of rectal mucosal prolapse, excessive rectal valve, internal sphincter relaxation, and anal canal stenosis. The rectocele can be reduced or even disappear after the problem, and the symptoms of constipation can be relieved.

2. Eat more vegetables, fruits and foods rich in crude fiber, drink plenty of water, take 2 spoons of honey and mix it with 150-200 ml of boiling water before going to bed every day instead of tea, drink 1 cup of light salt water on an empty stomach in the morning, develop a reasonable diet plan, establish good eating habits, maintain the nutrition of the diet, choose light, high-protein, high-calorie, high-vitamin, easily digestible foods, such as lean meat, green vegetables, fish, eggs, etc., and eat less spicy and irritating foods.