"Thanks to the director of the road, otherwise, I was really tossed 'dead' by this disease.。In the anorectal ward of the Provincial Hospital affiliated to Shandong First Medical University (Shandong Provincial Hospital), Zhang Ling (a pseudonym), who was preparing to be discharged, listened to Lu Yongchao, deputy director of the anorectal department, and red eyes several times。

　　Engaged in the anorectal work for more than 20 years, Lu Yongchao received countless "Zhang Ling", and also had a more profound understanding of the occupation of "anorectal doctor"。He often said: "The anorectal profession is dirty and tired, but many patients suffer from pain and are full of expectations, and it is our value to relieve patients' intractable pain.。”

　　Close the hemorrhoid,

　　Patients avoid 'nightmare' of bleeding after surgery

　　An elderly female patient in Heze City came to the provincial hospital and walked into Lu Yongchao's consulting room。After confirming that the patient was a mixed ring hemorrhoid, Lu Yongchao quickly performed a closed hemorrhoidectomy for her。On the fifth day after surgery, the patient was discharged successfully。The patient (incision) had largely healed by the time of review at 3 weeks after discharge。

　　"Ten years ago, such an efficient healing rate would have been unthinkable。Lu Yongchao introduced that the incidence of hemorrhoid disease is as high as more than 80%。Although the pressure of defecation is low after the traditional open surgery, the open wound healing is slow and the risk of infection and bleeding is high。

　　Especially for most patients with severe hemorrhoids combined with heart disease, the open operation with external stripping and internal ligature has a higher risk of bleeding。"Such patients are often combined with coronary heart disease, diabetes and other basic diseases, many of them have also done stent implantation, valve replacement, kidney transplantation and other major operations, often need lifelong oral anticoagulant and immunosuppressive drugs, which leads to patients after the risk of massive bleeding greatly increased, serious and even life-threatening.。"Lu Yongchao introduced。

　　Is there a way to reduce the occurrence of bleeding and infection？About a decade ago, after scouring the literature, Lu began experimenting with closed hemorrhoidectomy。"Closed excisions can greatly reduce the risk of postoperative bleeding and reduce discomfort, in addition, can accelerate healing, and the postoperative anal canal has a more natural and complete flexibility.。"Lu Yongchao introduced。

　　Despite the obvious advantages, at that time, this was a road that had not been traveled before。With no ready-made experience to follow, Lu Yongchao fumbled step by step。Although the road is difficult, the line is coming。"From full open surgery, to half open and half closed, and then to full closed resection, I walked for nearly ten years。"Lu Yongchao said。

　　Meanwhile, in order to solve the disadvantages of high tension and obvious pain during postoperative defecation that closed resection may face, and to prevent the problems of anal canal stenosis and defecation difficulty in patients after surgery, Lu Yongchao gradually explored the way of longitudinal incision and transverse suture, effectively reducing the formation of anal stenosis and external hemorrhoidal skin pad。

　　"In 2023, our department performed more than 900 hemorrhoidectomy procedures, most of which were closed procedures。The postoperative results are obvious, the bleeding rate and infection rate of patients are greatly reduced, and the healing speed is also faster。"Lu Yongchao said。

　　"Cavity" internal treatment "fistula",

　　The length of hospital stay was reduced from 30 days to 5 days

　　Some time ago, Zhang Yunhai (a pseudonym), 30 years old, suffered from abdominal distension pain, and a foreign body sensation in the anus。Introduced by a friend, he made an appointment with Lu Yongchao's expert clinic, from Liaocheng to the provincial hospital。After examination, Zhang Yunhai was diagnosed with high complex anal fistula (intersphincter fistula).。

　　"Among anorectal diseases, the incidence of anal fistula is second only to hemorrhoids。Lu Yongchao introduced, among them, the high complexity of anal fistula is recognized as a "problem" in the industry, "the location of the lesion is high, and the operation is very difficult."。If not timely and effective treatment, easy to lead to rectovaginal fistula, rectourethral fistula and other complications, may even be due to infection sepsis, sepsis and life-threatening。

　　For these patients, surgical resection is the main treatment。Although the traditional external incision is helpful to control the disease, it is easy to damage the anal sphincter and cause complications such as complete or incomplete anal incontinence。And this kind of surgery often requires at least three months of recovery time, during which every defecation, dressing change is a "torture" for patients.。

　　"The role of the doctor is not to do an operation, but to pay attention to the quality of life of the patient after the operation and pay attention to the feelings of the patient.。"Lu Yongchao said。Looking at the patient's facial features distorted by pain, Lu Yongchao secretly determined, "We must find a better solution.。”

　　In recent years, inspired by minimally invasive techniques, Lu Yongchao applied the operation of preserving sphincter muscle to the treatment of high complexity anal fistulas。

　　The endorectal fistula received by the patient Zhang Yunhai is a new operation carried out by Lu Yongchao in recent years。"Before the operation, I saw the patients walking around the ward, and I was so scared that I almost gave up。Thanks to Director Lu enlightened me, I was trembling on the operating table。Zhang Yunhai introduced that what he did not expect was that he could get out of bed on the day of surgery, and on the fourth day after surgery, he went through the discharge procedures。"During the recovery period, there was a little bit of discomfort, but the overall feeling was good。The operation was so worth it!"Zhang Yunhai smiled。

　　"The operation was worth it!That's what we doctors love to hear。Lu Yongchao introduced that in addition, for different patients, Lu Yongchao also carried out transanal intersphincterotomy (TROPIS) and improved Hanley surgery together with colleagues in the department。

　　The promotion and application of the new operation will ultimately benefit the patients。"In the past, some patients needed to stay in the hospital for more than a month, but now it only takes four or five days on my side;The recovery cycle used to take at least two or three months, and now it takes about two months to fully recover。"Lu Yongchao said。

　　Minimally invasive treatment "off",

　　Remove the "tail" from embarrassment and move on to a new life

　　Some time ago, the patient, Ms. Feng, found Lu Yongchao because of the recurrence of rectal prolapse。"I have high blood pressure, coronary heart disease, three previous hemangioma surgeries, three rectal prolapse surgeries and a hysterectomy。Zhang Ling introduced, because the condition is complex, many times to seek medical results。

　　Rectal prolapse, also known as proctosis, is a disorder of pelvic floor function。After defecation, the patient has a "tail" shaped mass (rectal mucosa) out of the anal mouth, embarrassment does not say, and occasionally stool incontinence, quality of life plummets。For severe patients with rectal prolapse, surgical treatment is undoubtedly the most effective method。

　　Compared with hemorrhoids and fistulas, the number of patients with rectal prolapse is much less。"Although there are few patients, it is necessary to master cutting-edge technologies as soon as possible to help patients remove pain.。"Lu Yongchao said。

　　Previously, during a study trip, Lu came across rectal mucosal resection for transanal prolapse (Delorme surgery and Altermier).。This procedure has little damage to the patient's body, good treatment effect, and the advantages of being repeatable make Lu Yongchao shine at the moment。In order to allow more patients to benefit from it, he actively studied and practiced, and took the lead in carrying out this procedure across the province in 2018。

　　"The patient is a young man in his 20s with a rectal prolapse of 10 cm, which is very serious。Lu Yongchao recalled that after the operation, the patient had some complications, but soon recovered。

　　The initial battle was successful, since then, Lu Yongchao has successfully carried out a number of such operations, and the confidence to overcome the problem of "proctocele" is more and more sufficient。

　　Out of confidence in his own medical skills and sympathy for the patient's pain, after carefully inquiring about Zhang Ling's medical history, Lu Yongchao decisively left her behind and arranged the operation for the first time。"I didn't expect to be able to operate so soon, some time ago, I stayed in a hospital for 24 days to prepare for surgery, and later because of high blood pressure, was pushed out of the operating room.。Zhang Ling said that the most exciting thing for her is that the body recovered quickly after the operation, "seeing better day by day", and reached the discharge standard on the fourth day after the operation。

　　More than 20 years have passed, Lu Yongchao's temples have been infected with white frost, but he is still happy to run in the anorectal department, with their own learning, to solve the pain of patients。He said: "The happiest thing is to see the patient's smile after recovery。”