hoop around the anus

Surrounding around the anus is used for surgical treatment of rectal prolapse. Pediatric rectal anal prolapse refers to rectal prolapse, which refers to an common disease of infants and young children that is turned out of the anus, rectum, and colon. The vast majority are between 2 and 3 years old. In normal children and adults, the rectum and anal canal are not in a straight line. The rectum bends forward and slopes forward, forming an angle with the anal canal. When the abdominal pressure increases, the pressure directly acts on the posterior wall of the rectum. . In infants, the curvature of the ankle is small, the development of the humerus is not obvious, and the rectum is almost vertical. When the intra-abdominal pressure is increased due to various reasons, the pressure is directly transmitted to the appendix, and the rectum is displaced outward. In addition, the position of the rectal bladder in the child is low, the sigmoid mesenteric is too long, and the tissue around the rectum is poorly developed. On the basis of the combination of chronic diarrhea, malnutrition, reduction of adipose tissue in the rectal fossa, reduced support for the rectum, coupled with weak external anal sphincter and pelvic floor muscles, can not resist the above pressure for a long time, over time, rectum can occur Prolapse. The rectal prolapse can be divided into 3 types: type 1, rectal mucosal prolapse, because the anal canal or rectal mucosa is separated from the muscular layer and is removed from the anus. Type 3: The pelvic floor structure is telescopically prolapsed, the distal end of the sigmoid colon is displaced downward, and the rectal anal canal is placed outside the anus. This type of child is rare. Children with rectal prolapse should first take non-surgical comprehensive treatment, most of the children can self-heal, including treatment of chronic diarrhea, malnutrition, correct long-term sitting basin, develop good bowel habits, etc., if the effect is not good, then consider surgery treatment. The purpose of various surgeries is to strengthen support for the rectum and prevent prolapse. The ann around the annulus is wrapped around the perianal tissue with silver wire (or stainless steel wire, nylon thread), in order to stimulate the perianal connective tissue hyperplasia, support the rectum after the scar is formed, and prevent the escape. Treatment of diseases: rectal prolapse Indication The anal around the annulus is suitable for rectal prolapse caused by the anal external sphincter weakness. Contraindications 1. The mucous membrane that has been removed has necrosis, and the perianal skin is erosive or infected. 2. Patients with chronic diarrhea who have not been corrected before surgery. Preoperative preparation 1. Clean the intestine before surgery. 2. Apply antibiotics to prevent infection. 3. When prolapsed mucosal edema, 3 to 5 days before surgery, first use 1:5000 potassium permanganate bath, until the edema subsides and then injection. Surgical procedure 1. After disinfecting the perianal skin and rectum, the surgeon uses the left hand to extend into the anus to protect the rectal mucosa from damage. A 0.5 cm radial incision was made 1.5 cm from the anal margin of the anus. 2. Take a semi-circular thick round needle, wear stainless steel wire or silver wire, penetrate through the posterior median incision, pass through the subcutaneous tissue on the left side of the anus, and pass through the front median incision. The steel wire (silver wire) is left under the subcutaneous side of the perianal side. Within the organization. Then, it is inserted through the right side of the front midline incision and is pierced from the posterior median incision. 3. The assistant tightens the silver wire behind the anus, so that the silver hoop is tightened around the operator's index finger, so that the surgeon can freely pass the end of the index. After the excess silver wire is cut, it is buried in the subcutaneous tissue, and then the incision is sutured intermittently with a thin wire. complication 1. Infection: Infection may make silver silk difficult to retain, and eventually the surgery fails. 2. Rectal necrosis: mainly caused by the tight binding of silver wire.