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Hemorrhoidectomy with lateral ultrasonic dissection in cutting mode in patients with stages 3–4 hemorrhoids

https://doi.org/10.33878/2073-7556-2024-23-2-85-92

Abstract

AIM: to assess original method of hemorrhoidectomy with lateral ultrasonic dissection in cutting mode in patients with stages 3–4 hemorrhoids.
PATIENTS AND METHODS: a retrospective study included 140 patients with hemorrhoids 2–4 stages. In the main group (n = 80), an original technique of lateral ultrasound dissection in cutting mode was used (patent for invention No. 2722997). Patients in the control group (n = 60) underwent Milligan-Morgan hemorrhoidectomy using electrosurgical scalpel.
RESULTS: significant differences were achieved in intensity of pain syndrome, morbidity rate, which were significantly in the main group. Histology showed that the depth of coagulative necrosis when in the original technique was 145 ± 25 µm vs 1730 ± 180 µm in the controls (р < 0,001). Anorectal manometry data, significantly less dysfunction anal sphincter was noted in the postoperative period in the main group.
CONCLUSION: hemorrhoidectomy with lateral ultrasonic dissection in cutting mode reduces tissue trauma, morbidity rate and intensity of pain, and also promotes rapid restoration of anal continence.

About the Authors

A. A. Sazonov
Military Medical Academy named after S.M. Kirov
Russian Federation

 Academician Lebedev st., 6, St. Petersburg, 194044, Russia 



N. A. Maistrenko
Military Medical Academy named after S.M. Kirov
Russian Federation

 Academician Lebedev st., 6, St. Petersburg, 194044, Russia 



P. N. Romashchenko
Military Medical Academy named after S.M. Kirov
Russian Federation

 Academician Lebedev st., 6, St. Petersburg, 194044, Russia 



A. G. Ardankin
Military Medical Academy named after S.M. Kirov
Russian Federation

 Academician Lebedev st., 6, St. Petersburg, 194044, Russia 



References

1. Aibuedefe B, Kling SM, Philp MM. An update on surgical treatment of hemorrhoidal disease: a systemic review and meta-analysis. Int J Colorectal Dis. 2021;36(9):2041–2049.

2. Davis BR, Lee-Kong SA, Migaly J, et al. The American society of colon and rectal surgeons clinical practice guidelines for the management of hemorrhoids. Dis Colon Rectum. 2018;61:284–292.

3. Shelygin Y.A., Frolov S.A., Titov A.Y., et al. Clinical recommendations of the Association of Coloproctologists of Russia for the diagnosis and treatment of hemorrhoids. Koloproktologia. 2019;18(1):13–15. (In Russ). doi: 10.33878/2073-7556-2019-18-1

4. Lohsiriwat V. Treatment of hemorrhoids: A coloproctologist’s view. World J Gastroenterol. 2015;21:9245–9252.

5. Simillis C, Thoukididou SN, Slesser AA, et al. Systematic review and network meta-analysis comparing clinical outcomes and effectiveness of surgical treatments for haemorrhoids. Br J Surg. 2015;102:1603–1618.

6. Ektov V.N., Somov A., Kurkin A.V., et al. Choice of treatments for chronic hemorrhoids. Vestnik eksperimental’noy i klinicheskoy khirurgii.2020;13(4):353–361. (In Russ). doi: 10.18499/2070-478X-2020-13-4-353-361

7. Gerbershagen HJ, Aduckathil S, Albert JM, et al. Pain Intensity on the First Day after Surgery. Anesthesiology. 2013;118(4):934–944.

8. Mushaya CD, Caleo PJ, Bartlett L, et al. Harmonic scalpel compared with conventional excisional haemorrhoidectomy: a meta-analysis of randomized controlled trials. Tech Coloproctol. 2014;18:1009–1016.

9. Shelygin Y.A., Blagodarny L.A. Open hemorrhoidectomy with ultrasonic scalpel. M., 2002; 45 p. (In Russ).

10. Armstrong DN, Ambroze WL, Schertzer ME, et al. Harmonic Scalpel vs. electrocautery hemorrhoidectomy: a prospective evaluation. Dis Colon Rectum. 2001;44:558–564.

11. Danilov M.А., Atroshchenko A.O., Khatkov I.E. Benefits of using harmonic focus in open hemorrhoidectomy. Koloproktologia. 2016; 55(S1):24–25. (In Russ).

12. Maistrenko N.A., Sazonov A.A., Makarov I.A. The method of hemorrhoidectomy with ultrasonic lateral dissection in cutting mode and ligation of the vascular pedicle. Patent for the invention of the Russian Federation №2722997. 05.06.2020. (In Russ).

13. Sazonov A.A., Maistrenko N.A., Romashchenko P.N., et al. Morphofunctional justification of the results of hemorrhoidectomy with lateral ultrasonic dissection in cutting mode. Vestnik Ros Voyenno-meditsinskoy akademii. 2023;25(1):43–50. (In Russ). doi: 10.17816/brmma72344

14. Shelygin Y.A., Titov A.Yu., Abriczova M.V. Modified classification of haemorrhoids. Koloproktologia. 2015;52(2):4–10. (In Russ).


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For citations:


Sazonov A.A., Maistrenko N.A., Romashchenko P.N., Ardankin A.G. Hemorrhoidectomy with lateral ultrasonic dissection in cutting mode in patients with stages 3–4 hemorrhoids. Koloproktologia. 2024;23(2):85-92. https://doi.org/10.33878/2073-7556-2024-23-2-85-92

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