Year 2013 Vol. 21 No 1

GENERAL AND SPECIAL SURGERY

S.V. SHAKHRAI

COMBINED SURGICAL TREATMENT TECHNIQUE OF CHRONIC HEMORRHOIDS

SEE Belarusian Medical Academy
of Postgraduate Education,
The Republic of Belarus

Objectives. To study the results and carry out a clinical analysis of the complex surgical treatment technique of patients with chronic hemorrhoids including laser radiation using (1,56 microns) and transanal suture ligation and mucopexy.
Methods. 52 patients with chronic hemorrhoid were included in the research. The patients were divided into two groups. The control group was made up of 30 patients with the 3rd stage of the disease. All patients of this group were subjected to a standard technique (open). The second (main) group was made up of 22 patients with the 3rd stage of chronic hemorrhoid who had undergone a submucous laser destruction of the hemorrhoidial nodes by means of infrared radiation which coagulates tissue (wavelength of 1560 nm) and transanal suture ligation and mucopexy of hemorrhoids. Procedures were carried out under local anesthesia by instrument for laser volumetric destruction of hemorrhoid worked out by the authors.
During the first postoperative week the patients state was daily assessed; then weekly during a six-month period after the operation. Wound healing rate, the presence of local purulent inflammatory changes, hemorrhage as well as dysuric disorders development in the postoperative period have been assessed.
Results. Comparison of the average objective and subjective indicators at the monitoring of the operation and the postoperative period shows the advantages of the suggested combined technique with use of laser destruction of the hemorrhoid and mucopexy versus a standard hemorrhoidectomy. Statistically significant differences were observed between the groups of comparison; at the same time both the pains induced by defecation and the pain reaction during the postoperative period at rest were considerably lower the 2nd group. The period of the postoperative rehabilitation was shorter as well.
Conclusions. The designed combined surgical method for the treatment of chronic hemorrhoids can be a mini-invasive alternative to hemorrhoidectomy and be recommended to be applied in the ambulant operating room or outpatient department of the hospital with short-staying of patients.

Keywords: chronic hemorrhoid, hemorrhoidectomy, mini-invasive treatment, laser destruction, mucopexy
p. 52 57 of the original issue
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Address for correspondence:
220107, Respublika Belarus' g. Minsk, ul. Korzhenevskogo, d. 4, GUO Belorusskaia meditsinskaia akademiia poslediplomnogo obrazovaniia, kafedra neotlozhnoi khirurgii s kursom ambulatornoi khirurgii,
e-mail: s.shakhrai@mail.ru,
Shakhrai Sergei Vladimirovich
Information about the authors:
Shakhrai S.V. PhD, associate professor of the emergency surgery chair with the course of ambulant surgery of SEE Belarusian Medical Academy of Postgraduate Education.
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