Preview

Koloproktologia

Advanced search

COMBINED MINIMALLY INVASIVE TREATMENT OF HEMORRHOIDS

https://doi.org/10.33878/2073-7556-2016-0-2-12-16

Abstract

THE AIM of the study was to develop a minimally invasive technique that does not have the disadvantages of traditional surgical treatment, does not have any restrictions in patients with external hemorrhoids as in HAL-RAR method. Technique that is more effective than HAL-RAR and isolated laser destruction methods, in the treatment of patients with chronic hemorrhoids stage II-III. MATERIALS AND METHODS. We developed a combined method of treatment of the patients with hemorrhoids, that unites artery ligation under the ultrasound control with Doppler effect and submucous subdermal laser destruction of internal and external hemorrhoids. We studied the safetiy and effectiveness of the developed method. The study included 100 patients with chronic hemorrhoids stage II and III, the patients were treated with the use of combined methodology HAL-laser (study group), the method HAL-RAR (1 control group) and closed hemorrhoidectomy linear stapler (control group 2). RESULTS. The analysis showed that the combined method HAL-laser has higher efficiency than the method HAL-RAR, and thus is as safe and well tolerated in patients. Its not so efficient compare to conventional hemorrhoidectomy because of the risk of a cosmetic defect, but does not increase the risk of recurrence of the disease, reduces the risk of complications and more endurable for the patients, it also allows to reduce the time of disability.

About the Authors

G. V. Rodoman
RNRMU named after N.I.Pirogov; Moscow city hospital № 24
Russian Federation


L. V. Kornev
Moscow city hospital № 24
Russian Federation


T. I. Shalaeva
RNRMU named after N.I.Pirogov; Moscow city hospital № 24
Russian Federation


V. A. Cherner
RNRMU named after N.I.Pirogov; Moscow city hospital № 24
Russian Federation


References

1. Воробьев Г.И., Благодарный Л.А., Шелыгин Ю.А. Геморрой: руководство для практических врачей. 2-е изд. - М.: Литтерра, 2010. - 200 с.

2. Гаин М.Ю. Лазерные технологии в лечении геморроя. Новости хирургии. - 2013. - т. 21. - 1. -с. 97.

3. Даценко Б.М., Даценко А.Б. Геморрой. - Харьков: Новое слово, 2011. - 144 с.

4. Davies J., Duffy D., Boyt N. et al. Botulinum toxin (Botox) reduced pain after haemorrhoidectomy. Dis. Colon Rectum. - 2003. - 46. - р. 1097-1102.

5. Godebergt Ph. Anorectal diseases. - Paris: Med. -Scien., 2008. - 279 р.

6. Hardy A., Chan C.L., Cohen C.R. The surgical management of haemorrhoids-a review. Dig.Surg. -2005. - 22. - р. 26-33.

7. Johaimsson H.O., Graf W., Pahlman L. Long-term results of haemorrhoidectomy. Eur. J. Surg. - 2002. -168 (8-9). - p. 485-9.

8. MacRae H.M., Temple L.K., McLeod R.S. A metaanalysis of hemorrhoidal treatments. Semin. C. R. Surg. - 2002. - 13. - p. 77-83.

9. Morinaga K., Hasuda K., Ireda T. A novel therapy for internal haemorrhoids: ligation of the haemorrhoidal artery with a neewly devised instrument (Moricorn) in conjuction with a Doppler flowmeter. Am.J.Gastroenterol. - 1995. - 90 (4). - p. 610-613.

10. Plapler H. A new method for hemorrhoid surgery: experimental model of diode laser application in monkeys. Photomed Laser Surg. - 2008. - Vol. 26. -№ 2. - p. 143-146.

11. Scheyer M. Doppler-guided recto-anal repair: a new minimally invasive treatment of hemorrhoidal disease of all grades according to Scheyer and Arnold. Gastroenterol. Clin. Biol. - 2008. - 32. - р. 664.

12. Singer M.A., Cintron J.R., Fleshman J.W. et al. Early experience with stapled hemorrhoidectomy in theUnited States. Dis. Colon Rectum. - 2002. -45 (3). - р. 360-369.

13. Sutherland L.M., Burchard A.K., Matsuda K. et al. A systematic review of stapled hemorrhoidectomy. Arch. Surg. - 2002. - 137 (12). - р. 1395-1407.

14. Wilkerson P., Strbac M., Reece-Smith H. et al. Doppler-guided haemorrhoidal artery ligation: longterm outcome and patient satisfaction. Colorectal Dis. - 2008. - 11. - р. 394-400.


Review

For citations:


Rodoman G.V., Kornev L.V., Shalaeva T.I., Cherner V.A. COMBINED MINIMALLY INVASIVE TREATMENT OF HEMORRHOIDS. Koloproktologia. 2016;(2):12-16. (In Russ.) https://doi.org/10.33878/2073-7556-2016-0-2-12-16

Views: 839


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2073-7556 (Print)
ISSN 2686-7303 (Online)