Efficacy of minimally invasive procedures in hemorrhoids treatment (grade II-III)

The objective of the work is to improve the results of treating patients with hemorrhoids (grade II-III), through the development, implementation and validation of minimally invasive procedures.Material and Methods. The effectiveness of minimally invasive and combined methods of treatment was analyzed. 320 patients with chronic hemorrhoids (grade II-III) were observed in dynamics. 252 patients underwent outpatient surgery, 68 patients were operated in hospital but stayed there only for one day. The patients underwent the following procedures: diathermocoagulation - 44 patients (13.75 %); sclerotherapy - 20 patients (6.25 %); latex ligation of external hemorrhoid - 86 patients (26.88 %); ultrasound guided sclerotherapy by means of surgical complex “Prokson” - 65 patients (20.31 %), sclerotherapy hemorrhoid treatment (desarterization of internal hemorrhoids or mucosal lifting) - 105 patients (32.81 %).The results of each method were evaluated according to the following criteria: good results (absolute recovery and the lack of the major symptoms of the disease and absence of complaints), satisfactory results (significant decrease in frequency and intensity of bleeding and hemorrhoids prolapsed degree), bad results (hemorrhoids symptoms remain the same as compared to the initial stage of treatment, development of inflammatory and hemorrhagic complications). Results. The authors proved that a differentiated approach is required to detect the indications and choose the method of minimally invasive surgery according to the disease pattern (form, stage, inflammatory changes, bleeding), as well as to conduct any particular procedure, taking into account the stage disease and complications. Conclusion. The results showed that the most effective techniques for hemorrhoids treatment (grade III) are ultrasound guided sclerotherapy and Doppler-controlled desarterization. Sclerotherapy is effective for bleeding control and as a kind of pre-surgery treatment. The best results for hemorrhoids (grade III) treatment were obtained by combining desarterization with sclerotherapy or mucosal lifting.