ALTA Therapy in Treating Rectal Mucosal Prolapse after Whitehead's Operation

概要

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Objective: Disorders after Whitehead's operation include symptoms such as anal bleeding and rectal mucosal prolapse, as well as sharp pain and mucous discharge. The disease is often difficult to treat. We performed treatment using ALTA therapy, a sclerotherapy for internal hemorrhoids. Patients: Between May 2006 and October 2010, 40 cases were operated on for rectal mucosal prolapse after Whitehead's operation. Presenting symptoms included mucosal prolapse in 12 patients, bleeding in 8, and both mucosal prolapse and bleeding in 20 patients. The surgeon used an anoscope to inject ALTA solution according to the four-step injection method when the hemorrhoid mass remainder and recurrence was the main concern. When circumferential mucosal prolapse was the main concern, 0.5 to 1 ml of ALTA solution was injected into the submucosa at tens of different sites. Manual dilation or sliding skin graft was performed for anal stenosis. Results: Total injection volume of ALTA solution was 26.6 ml. Recurrence occurred in 3 cases (7.5%). All 3 patients required repeat ALTA therapy. Conclusion: ALTA therapy is a simple and effective treatment for rectal mucosal prolapse after Whitehead's operation, with few complications.