Hardware- controlled bipolar electrocoagulation as a method of surgical treatment of chronic combined hemorrhoids
Science Articles / / April 20, 2016
Vasiliev SV Sobolev SN, Itkin IM State Medical University.Acad.IPPavlova,
Chair of Surgical Diseases with the course of Coloproctology (Head. Department of. Acad. Of Medical Sciences prof. Yaitsky NA)
purpose of the study.The aim of this study is to evaluate the advantages and disadvantages of performing a hemorrhoidectomy procedures: standard operation Milligan-Morgan performed using conventional monopolar electrosurgical installatio
Materials and Methods.Since June, 2002.to January 2003.St. Petersburg city center coloproctological were operated on 120 patients with chronic combined hemorrhoids stage III - IV according to the International Classification of using hardware-controlled bipolar elektrkoagulyatsii (LigaSure installation).The control group consisted of 120 patients operated by the standard method (open hemorrhoidectomy for Milliganu- Morgan using monopolar electrosurgical installation).
in both groups were evaluated: duration of surgery, bleeding during surgery, pain (using an international visual analogue scale and the need for the appointment of narcotic analgesics in the postoperative period), the presence and severity of postoperative complications: dizuricheskih disorders, post-operative bleeding, the timingrecovery of patients disability, the healing of surgical wounds.To investigate the effect of a technique of surgery on the function of the sphincter apparatus of the rectum and anal canal to all patients, both before surgery and in the postoperative profilometry was performed in the domestic unit "Kolodinamik-3."Determination of the healing rate studies conducted using smears with wound surfaces in the perianal area, at different times of postoperative period.
Results: When comparing two hemorrhoidectomy procedures observed significant benefits in a group of patients operated using a hardware-controlled bipolar electrocoagulation (installation LigaSure): shorter duration of surgery, the almost complete absence of bleeding during surgery and in the postoperative period, a significant reduction in postoperative painsyndrome, lack dizuricheskih disorders, rapid restoration of working capacity of patients and decrease in terms of healing of postoperative wounds.Timing recovery device sphincter tone in the postoperative period did not differ in both groups of patients.
Conclusion.A comparative evaluation of the two hemorrhoidectomy procedures provided data on the significant decrease of post-operative pain, a significant reduction in the number of postoperative complications and reducing the time of surgery in patients with chronic combined hemorrhoids stage III -IV International Classification using the procedure of hardware-controlled bipolar electrocoagulation.