This journal is
indexed in Scopus
Year 2015 Vol. 23 No 4
GENERAL & SPECIAL SURGERY
M.Y. GAIN, S.V. SHAKHRAI, Y.M. GAIN
HEMORRHOIDAL LASER COAGULATION AND MUCOPEXY IN THE SURGERY OF GRADE II AND III CHRONIC HEMORRHOIDS: A RANDOMIZED TRIAL
SEE "Belarusian Medical Academy of Post-Graduate Education"
The Republic of Belarus
Objectives. To evaluate the efficiency of hemorrhoidal laser coagulation and mucopexy in complex treatment of grade II and III chronic hemorrhoids by J. Goligher classification (1975).
Methods. The patients were divided into two groups according to the surgical intervention. In the 1st (main) (n=45) group the minimally invasive surgery – subcutaneous-submucous hemorrhoidal laser coagulation and mucopexy with proximal suture artery ligation were performed. In 34 patients (75,6%) the procedure was performed under local anesthesia, in 11 patients (24,4%) – under spinal anesthesia. In the control group (n=45) the closed Ferguson’s hemorrhoidectomy was carried out under spinal anesthesia. A comparative analysis of the results from a single-center, prospective, randomized, controlled study has been conducted.
Results. In comparability the final clinical effect and radicalism with the hemorrhoidal laser coagulation of the designed technique has surpassed the closed hemorrhoidectomy in the indices of the local edema duration (median terms of its disappearance in compared groups are 1 and 4,5 days, p=0,0000594, z=−4,01521 Mann-Whitney U Test), of pain syndrome intensity in 89,1% of patients after hemorrhoidectomy the observed pain relief associated with 1-2% promedolum injections, this was not necessary in the main group), the qualitative and quantitative characteristics of the postoperative complications (frequency of early complications lack in compared groups made up 43 (95,6%) and 29 (64,4%), p=0,0018, long-term complications – 43 (95,6%) and 31 (68,9%), p=0,0017, Chi-square), and also according to other indices have been established.
Conclusion. The designed method of subcutaneous-submucous laser coagulation with wavelength of 1,56 mn in combined with desertification hemorrhoids through suture ligation and mucopexy proven to be less invasive procedure used for treatment of grade II and III chronic hemorrhoids compared with closed hemorrhoidectomy.
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220013, Republic of Belarus,
Minsk, ul. P. Brovki, d. 3, korp. 3,
GUO "Belorusskaya meditsinskaya akademiya
kafedra neotlozhnoy khirurgii,
tel. mob.: 375 44 557-88-15,
Gain Mihail Yurevich
Gain M.Y. PhD, an assistant of the emergency surgery chair of SEE "Belarusian Medical Academy of Post-graduate Education".
Shakhrai S.V. PhD, an associate professor of the emergency surgery chair of SEE "Belarusian Medical Academy of Post-graduate Education".
Gain Y.M. MD, professor, Vice-rector on scientific work of SEE "Belarusian Medical Academy of Post-graduate Education".