Surgical treatment of patients with hemorrhoids by using traditional and minimally invasive methods

Abstract

Background: Hemorrhoids are a common pathology of the ano-rectal region and their treatment remains relevant. New minimally invasive methods of surgical treatment of hemorrhoids have been developed recently. Transanal Doppler-Guided Hemorrhoidal Artery Ligation (DG-HAL) of internal hemorrhoids is an up-to-date minimally invasive surgical method of hemorrhoid treatment. In the Republic of Moldova, many patients seek medical help only in advanced stages with large prolapse. It is not always possible to resolve the problem with minimally invasive methods. In medical literature there is little elucidation of the simultaneous combination of the DG-HAL method with the excision of external hemorrhoidal nodes. In the Republic of Moldova this study is being carried out for the first time. The authors present the results of combined surgical treatment of patients with hemorrhoids. The combined method of surgical treatment of hemorrhoidal disease has been implemented in our country and the efficacy of the method for individual approach has been demonstrated. Material and methods: The results of the surgical treatment of 15 patients with the diagnosis of chronic hemorrhoids III-IV grade were evaluated. Patients were treated with the combined surgical method (DG-HAL with excision of hypertrophied external hemorrhoids and / or skin tags). Results: Postoperative pain after “visual analogue scale” ranged from 3 to 6. Postoperative hospitalization constituted from 1 to 6 days. The duration of the surgery during adoption of approach was 30-60 minutes, but in the years 2016-2017 it constitutes 25-40 minutes. Severe complications have not been detected. Conclusions: The individual approach by combined surgical treatment of patients with hemorrhoidal disease improves treatment outcomes.