rectal instruments

OPERATIONS FOR CONDYLOMAS OF THE ANUS


By • Дек 26th, 2010 • Category: Anus

Condylomas occur as a result of irritation of the pe-rianal skin by rectal discharges in proctitis of a viral etiology.

Prior to operation, the proctitis is treated by giving the patient medicinal enemas for 7 to 10 days daily (following a purgative enema) to instill 100 ml of 0.4 or 0.5 per cent Collarhol solution into the rectum.

In the last three preoperative days, the tumour should be painted daily with a 2 per cent tincture of iodine.

EXCISION OF CONDYLOMAS

This operation is indicated in cases of a condyloma with porous structure. Under local or combined inhala­tion anesthesia, and in the position as that for hemorrho-idectomy, the assistant draws the gluteal skin apart (Fig. 130,1), while the surgeon picks up the tumour with gauze and gradually cuts it off from the skin surface by means of a sharp scalpel held flatwise. Hemostasis is effected by means of clamps. The bleeding skin sur­face, which is covered with a network of bridges of intact epithelium (Fig. 130,2), is pressed by gauze dusted with sulfanilamide or xeroform. The large defects of epi­thelium are then closed with 1 or 2 catgut sutures (Fig. 130,3), and a pack soaked in balsamic ointment tucked into the wound, while a cotton-gauze dressing is applied externally. Opium tincture is given for 7 days. After 10 days, the treatment of proctitis with medicinal enemas is renewed. This course of treatment should be repeated” 4 to 5 times a year for 20 days at a time.

Operation for excision of anal condyloma

Fig. 130 Operation for excision of anal condyloma:

1. A large condyloma. The assistant separates the buttocks thus exposing the anal orifice.

2. After the tumour has been cut away, a large num­ber of small superficial wounds are left on the skin with bridges of intact epithelium between them.

3. Extensive skin defects are closed with catgut



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