Hemorrhoidectomy with lateral ultrasonic dissection in geriatric patients
https://doi.org/10.24884/0042-4625-2022-181-3-50-56
Abstract
The OBJECTIVE was to evaluate the efficacy and safety of hemorrhoidectomy with lateral ultrasound dissection in patients of older age groups.
METHODS AND MATERIALS. A comparative analysis of the immediate and long-term results of treatment in two groups of geriatric patients suffering from III–IV stages of hemorrhoids was carried out. The main included 27 patients who underwent hemorrhoidectomy using the original technique of lateral ultrasound dissection in the «cutting» mode. The control group consisted of 33 patients who underwent traditional Milligan–Morgan hemorrhoidectomy using electrocoagulation. To assess the traumaticity degree of interventions using light microscopy, pathomorphological changes in remote hemorrhoids were studied, and the dynamics of the wound process was traced.
RESULTS. The incidence of postoperative complications in the main and control groups was 7 % and 27 % (p=0.09). When assessing the dynamics of the intensity of the pain syndrome within 5 days after the intervention, significantly lower indicators were found in patients who underwent hemorrhoidectomy with lateral ultrasound dissection, which made it possible to significantly reduce the doses of analgesics. A comparative analysis of pathomorphological changes showed statistically differences in the extent of the coagulation necrosis zone, which was significantly less in patients of the main group.
CONCLUSION. The use of hemorrhoidectomy with lateral ultrasound dissection in geriatric patients reduces the incidence of complications and the intensity of the pain syndrome, as well as speed up their rehabilitation.
About the Authors
N. A. Maistrenko
Military Medical Academy
Russian Federation
Competing Interests:
Russian Federation
Maistrenko Nikolay A., Dr. of Sci. (Med.), Professor, Academician of RAS, Professor of the Department and Clinic of Faculty Surgery named after S. P. Fedorov
Saint Petersburg
Competing Interests:
The authors declare no conflict of interest
A. A. Sazonov
Military Medical Academy
Russian Federation
Competing Interests:
Russian Federation
Sazonov Alexey A., Dr. of Sci. (Med.), Deputy Head of the Department and Clinic of Faculty Surgery named after S. P. Fedorov
6, Academika Lebedeva str., Saint Petersburg, 194044
Competing Interests:
The authors declare no conflict of interest
P. N. Romashchenko
Military Medical Academy
Russian Federation
Competing Interests:
Russian Federation
Romashchenko Pavel N., Dr. of Sci. (Med.), Professor, Corresponding Member of RAS, Head of the Department and Clinic of Faculty Surgery named after S. P. Fedorov
Saint Petersburg
Competing Interests:
The authors declare no conflict of interest
A. G. Ardankin
Military Medical Academy
Russian Federation
Competing Interests:
Russian Federation
Ardankin Anton G., Senior Resident of the Clinic of Faculty Surgery named after S. P. Fedorov
Saint Petersburg
Competing Interests:
The authors declare no conflict of interest
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For citations:
Maistrenko N.A., Sazonov A.A., Romashchenko P.N., Ardankin A.G. Hemorrhoidectomy with lateral ultrasonic dissection in geriatric patients. Grekov's Bulletin of Surgery. 2022;181(3):50-56. (In Russ.) https://doi.org/10.24884/0042-4625-2022-181-3-50-56
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