Keywords
THD
hemorrhoidal dearterialization
Doppler-controlled dearterialization
closed sutureless hemorrhoidectomy
How to Cite
Abstract
In press
The aim of the work was to improve the results of surgical treatment of patients with hemorrhoids, based on the choice of tactics and selection of the optimal method of surgery for the patient, taking into account the advantages and disadvantages of using hemorrhoidectomy using various electrowelding equipment, or THD (Transanal Hemorrhoidal Dearterialization). Materials and methods: The use of THD and hemorrhoidectomy using electrowelding equipment for complicated hemorrhoids of stage II–IV was analyzed in 243 operated patients. Of these, 162 used THD in the DDD modification (Distal Doppler-guided Dearterialization), and 81 used "seamless" hemorrhoidectomy. Results of the studies and their discussion: Evaluation of the results of the operations included: assessment of the number of postoperative complications, intensity and duration of pain syndrome, wound regeneration rate, duration of patients' stay in the hospital, term of restoration of patients' working capacity. The length of hospital stay was [2.3±3] days after hemorrhoidectomy and [1.3±2] days after THD. The period of outpatient follow-up was [12–21] days for all patients. The working capacity of patients after hemorrhoidectomy was restored after [10–12] days. In patients after hemorrhoidectomy, the severity of pain syndrome, assessed by the Visual Analogue Scale, averaged 3.7 points, which corresponds to slight pain or tolerant pain during movements; in patients after THD – 2.4 points. A significant number of patients even refused anesthesia on the first day after surgery. As a result of the study, it was concluded that THD is a minimally invasive, at the same time, radical, surgical intervention. THD is appropriate for the surgical treatment of hemorrhoids of the II–III degree, especially complicated by bleeding. In stage IV it will be more expedient and clinically justified to perform hemorrhoidectomy using electrowelding equipment ("seamless" or "closed").
Keywords: hemorrhoids, THD, hemorrhoidal dearterialization, Doppler-controlled dearterialization, closed sutureless hemorrhoidectomy.
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