gnckКолопроктологияKoloproktologia2073-75562686-7303Russian Association of Coloproctology10.33878/2073-7556-2021-20-1-87-98gnck-1637Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWДопплер-контролируемая дезартеризация геморроидальных узлов. Техническая эволюция и результаты лечения (обзор литературы)Doppler-guided hemorrhoidal dearterialization. Technical evolution and results of treatment (review)https://orcid.org/0000-0002-5495-3101ЗагрядскийЕ. А.ZagriadskiǐE. A.

ул. Большая Молчановка, д. 32, строение 1, г. Москва

Evgeny A. Zagriadskiǐ 

Bolshaya Molchanovka str., 32, str. 1, Moscow

proctolog52@rambler.ruТолстыхВ. С.TolstyhV. S.

Зеленоград, Сосновая аллея, 6Ас1, г. Москва

Vladimir S. Tolstyh  

Zelenograd, Sosnovaya alleya, 6Ac1, Moscow

Медицинский центр «ОН КЛИНИК»РоссияMedical Center “ON-CLINIC”Russian FederationЗАО «НПФ «БИОСС»РоссияNPF “BIOSS”Russian Federation2021180320212018798Copyright © Загрядский Е.А., Толстых В.С., 20212021Загрядский Е.А., Толстых В.С.Zagriadskiǐ E.A., Tolstyh V.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ruproctology.com/jour/article/view/1637

Геморроидэктомия считается «золотым стандартом» лечения геморроидальной болезни, но ассоциируется с длительным реабилитационным периодом. По этой причине 20 лет назад был разработан инновационный метод лечения геморроя – допплер-контролируемая дезартеризация. Целью работы является анализ литературы о применении допплер-контролируемой дезартеризация в лечении геморроидальной болезни, техническая эволюция метода и анализ результатов лечения. Анализ литературы показывает, что допплер-контролируемая дезартеризация является безопасным и эффективным методом лечения геморроидальной болезни. Сочетание дезартеризации с трансанальной мукопексией улучшило результаты лечения у пациентов с III и IV стадией геморроя. Однако не при всех формах геморроидальной болезни можно получить адекватные результаты. Эффективность зависит от особенностей васкуляризации аноректальной зоны, степени разрушения связочного аппарата внутреннего геморроидального сплетения и степени увеличения наружного геморроидального сплетения. Адекватность выполнения дезартеризации и мукопексии требует объективного контроля для оценки эффективности проведенной манипуляции.

Hemorrhoidectomy is considered as the “gold standard” for hemorrhoidal disease, but is associated with a long rehabilitation period. For this reason, 20 years ago, an innovative method for hemorrhoids was developed – Doppler-guided hemorrhoidal dearterialization. The aim of the work is to analyze the literary data of the use of Doppler-guided dearterialization for hemorrhoidal disease, the technical evolution of the method and the analysis of the results. An analysis of the literature shows that Dopplerguided dearterialization is a safe and effective method for hemorrhoidal disease. The combination of dearterialization with transanal mucopexy improves outcomes in patients with hemorrhoids III and IV stages. However, good results can be obtained not in all forms of hemorrhoidal disease. The efficacy depends on the peculiar features of the anorectal zone vascularization, the degree of destruction of the suspensory ligaments of the internal hemorrhoidal plexus and the degree of enlargement of the external hemorrhoid plexus. The adequacy of the dearterialization and mucopexy requires an objective control for assessment of the procedure.

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The authors declare that there are no conflicts of interest present.