Choice of surgical treatment for chronic composite hemorrhoid

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Abstract

A comparative analysis of the treatment of 142 patients operated on chronic hemorrhoid stage III–IV has been passed by way of assess the results of using new version of hemorrhoidectomy. The age of patients ranged from 27 to 80 (mean age was 50.4±6.7). 86 (60.6%) patients were diagnosed with stage III chronic hemorrhoid, at 56 (39.4%) patients — the stage IV. For this study patients were divided into basic and controlled groups. The basic group consisted of 73 (51.4%) patients that have had hemorrhoidectomy using our modification. There were 69 (48.6%) patients in control group that have been operated by Milligan–Morgan method in second modify of State Scientific Center of Proctology using bipolar coagulator LigaSure. The level of pain was assessed in the early postoperative period by numeric rating scale. The patients had been operated by our method mentioned that the pain syndrome was less pronounced (3.2 against 4.9 balls), that required less painkillers in the early postoperative period. In the case of doing semicircle cuts on the border of anocutaneous crinkle and bringing down mucous membrane, the significant excision of the cavernous tissue doesn’t lead to contraction of the anal canal by that reduces the number of functional disorders after hemorrhoidectomy (4 figs, 1 table, bibliography: 7 refs).

About the authors

Oleg A. Litvinov

S. M. Kirov Military Medical Academy

Author for correspondence.
Email: koptata@mail.ru
SPIN-code: 3936-5599

M. D., D. Sc. (Medicine), professor of the Common Surgery Department

Russian Federation, bld. 6, Akademika Lebedeva str., Saint Petersburg, 194044

Evgeniy V. Zhitikhin

S. M. Kirov Military Medical Academy

Email: koptata@mail.ru
SPIN-code: 1984-5704

M. D., Ph. D. (Medicine), senior lecturer of the Common Surgery Department

Russian Federation, bld. 6, Akademika Lebedeva str., Saint Petersburg, 194044

Igor G. Ignatovich

S. M. Kirov Military Medical Academy

Email: koptata@mail.ru
ORCID iD: 0000-0003-3772-6131

M. D., Ph. D. (Medicine), associate professor of the Common Surgery Department

Russian Federation, bld. 6, Akademika Lebedeva str., Saint Petersburg, 194044

Hovannes A. Arutyunyan

S. M. Kirov Military Medical Academy

Email: koptata@mail.ru

M. D., Ph. D. (Medicine), teacher of the Common Surgery Department

Russian Federation, bld. 6, Akademika Lebedeva str., Saint Petersburg, 194044

Artur G. Arustamov

S. M. Kirov Military Medical Academy

Email: koptata@mail.ru

M. D., Ph. D. (Medicine), associate professor of the Common Surgery Department

Russian Federation, bld. 6, Akademika Lebedeva str., Saint Petersburg, 194044

Mikhail L. Grinev

S. M. Kirov Military Medical Academy

Email: koptata@mail.ru

M. D., Ph. D. (Medicine), teacher of the Common Surgery Department

Russian Federation, bld. 6, Akademika Lebedeva str., Saint Petersburg, 194044

References

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2. Fig. 1. Direction of the semicircular incision

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3. Fig. 2. Mobilization of the mucous membrane of the anal canal with cavernous bodies in the submucosal layer

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4. Fig. 3. The excess of the mucous membrane of the anal canal with cavernous bodies is gradually cut off with sutures

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5. Fig. 4. Interrupted sutures on the anoderm and mucous membrane: a - after removal of the cavernous tissue and excess mucosa on the left semicircle; b - the final view of the postoperative wound

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Copyright (c) 2020 Litvinov O.A., Zhitikhin E.V., Ignatovich I.G., Arutyunyan H.A., Arustamov A.G., Grinev M.L.

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