Comparative analysis of hemorrhoid treatment by electrocoagulation, bipolar electrosection and combined laser destruction

Objectives.To analyze the combined method of surgical treatment of internal hemorrhoids by submucosal laser destruction in combination with Doppler uncontrolled desarterization, mucopexy and electroexcision of the external component according to indications in comparison with traditional electrosurgical techniques.Material and methods of research. The study included 1386 patients with hemorrhoids of stages 2, 3 and 4, who were divided into three groups depending on the method of surgical treatment. Patients of the first group underwent hemorrhoidectomy according to the Milligan-Morgan method in the 2 modification of the State Proctology Research Institute with the use of an electrocoagulator under spinal anesthesia.Patients of the second group underwent similar surgical treatment, but with the use of a bipolar electrosection device also under spinal anesthesia. In the third group, all patients underwent submucous laser destruction of internal hemorrhoids with Doppler uncontrolled desarterization, supplemented according to indications with mucopexy and electroexcision of the external hemorrhoidal component. Surgical treatment was performed under intravenous anesthesia. Laser radiation of a diode device with a wavelength of 1,56 microns and a power of 10 W was used.Treatment results.The hybrid technique reduces the risk of postoperative bleeding due to better hemostasis in the immediate postoperative period and early formation of fibrous granulation tissue in the late postoperative period. Avoids the formation of rough scar tissue.Conclusion. The technique has technical simplicity, the possibilities of an individual approach to the patient, has no restrictions on the volume and stage of the disease. Reduces the level of postoperative complications, accelerates the rehabilitation period, and improves the quality of life of patients.