Poređenje hemoroidektomije laserom i hemoroidektomije metodom Milligan-Morgan – kratkoročni rezultati

Halit  Maloku; Ranko  Lazović; Hasime  Terziqi

doi:10.2298/VSP170125070M

Halit Maloku PhD Studies, Faculty of Medicine, University of Montenegro
Ranko Lazović University of Montenegro, Faculty of Medicine, PhD Studies, Podgorica, Montenegro
Hasime Terziqi Multi-Profile University Hospital for Active Medical Treatment and Emergency Medicine (UMHATEM), “N. I. PIROGOV”, PhD study, Sofia, Bulgaria

DOI: https://doi.org/10.2298/VSP170125070M

Keywords: hirurgija laserom, hemoroidi, hirurgija, operativne procedure, postoperativni period, postoperativne komplikacije.

Abstract

Apstrakt

Uvod/Cilj. Prema “vaskularnoj” teoriji arterijski priliv u gornjoj hemoroidalnoj arteriji dovodi do dilatacije hemoroidalnog venskog pleksusa. Laser hemoroidoplastika (LHP) je novi postupak primenjen u ambulantnom lečenju hemoroida u kojem se hemoroidalni arterijski protok krvi koji ishranjuje hemoroidalni pleksus zaustavlja laserskom koagulacijom. Cilj ove studije bio je poređenje između grupa bolesnika lečenih sa dve različite metode, laserom (LHP) i sa otvorenom hirurškom metodom – Milligan Morgan (MM). Metode. U ovu studiju bilo je uključeno 200 bolesnika sa hemoroidima trećeg stepena, starijih od 18 godina, od kojih je 100 bilo tretirano LHP metodom, dok je ostalih 100 bolesnika tretirano Milligan-Morgan hemoroidiektomijom. Parametri koji su se koristili za poređenje dve hirurške metode bili su: dužina hospitalizacije, postoperativni bol, prisustvo krvarenja i vreme potrebno da se bolesnici vrate normalnom životu. Rezultati. Rezutati su pokazali statistički značajnu razliku među metodama. Nivo postoperativnog bola bio je niži kod bolesnika u grupi lečenih LHP u odnosu na grupu bolesnika lečenih MM metodom (p < 0,0001). U grupi tretiranoj metodom LHP, krvarenje je bilo manje u odnosu na grupu koja je tretirana otvorenom hirurškom metodom (MM). Trajanje operacije, kao i dužina hospitalizacije bili su znatno kraći u grupi sa hemoroidoplastikom (LHP) u odnosu na grupu sa hemoroidektomijom (MM metoda). Zaključak. Dobijeni rezultati upućuju na značajne prednosti LHP metode u odnosu na metodu Milligan Morgan kod bolesnika sa hemoroidima trećeg stepena.

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