rectal instruments

OPERATION FOR TWO-STAGE EXCISION OF PERIANAL CONDYLOMAS


By • Дек 26th, 2010 • Category: Anus

In those cases with densely growing condylomas, it is necessary to resort to excision of the tumour in two or more stages by removing triangular areas of perianal skin together with some of the condylomatous growths. It will be seen from Figs 131,1; 131,2 and 131,3, that in no case should the total length of the removed triangular skin areas with condylomas exceed half of the circumfe­rence of perianal skin.

It is essential that the interior angle of the triangle flap being removed penetrate the anal canal to the pecti­nate line.

In dissecting away a skin flap, the surgeon should excise its superficial layer only, so as to facilitate subse­quent regeneration of the epithelium. Occasionally, a third triangular flap may be also removed (Fig. 131,3). After hemostasis, a well-soaked ointment pack is introduced in­to the rectum to cover the triangular wounds.

The first dressing is applied in three days. Thereafter dressings are made after a bath. Opium tincture is given for 7 days The patient is discharged 9 or 10 days after operation to be further ireated along ambulatory lines.

The second stage of the operation is performed 30— 35 days later and consists of the removal of skin areas with the remaining condylomas using the procedure just described (Fig. 131,4).

Postoperatively a long-term treatment of proctosig-moiditis with medicinal enemas should be started (0.5 per cent Sol. Collargoli 100 ml per enema each morning for 30 days following the purgative enema).

Operation for multi-stage excision of anal con­dylomas

Fig. 131 Operation for multi-stage excision of anal con­dylomas:

1. An area of skin with the tumour subject to remo­val is marked out with scalpel.

2. A triangular area of skin is removed along with the tumour.

3. Appearance of the wound after three triangular areas of skin have been removed.

4. Appearance of condylomas a month after the first stage of the operation.



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