Hemorrhoidal vessels

When sclerosing treatment of hemorrhoids as phlebosclerosing drugs used 2.3% solutions thrombovar, etoksisklerola and fibroveyna. Mechanism of action of these drugs are surfactants, ie, after their introduction into the lumen of the haemorrhoid is denaturation of proteins of the inner shell haemorrhoid, its thrombosis with subsequent obliteration of the lumen, bypassing the stage of the inflammatory process. Sclerosing treatment of hemorrhoids performed vrachomkoloproktologom on an outpatient basis. The method is that a syringe with two lugs and a long needle with limiter at its sharp edge with anoscope with illuminator into the lumen of the haemorrhoid closer to his leg injected 1,5-2 ml of sclerosing agent. At the same time, a drug may not be more than 2 haemorrhoid, since the introduction of more of the drug developed severe pain syndrome. If necessary, a second session be held no sooner than 12-14 days after decrease in the reparative process. Average duration of each session - about 10 minutes. When the first and second stages of the disease after sclerotherapy good results in 71-85% of cases in advanced stages - in 26-42% of patients. However, in the third and fourth stages of the unsatisfactory results are recorded in 31-62% of cases.

Quite effective minimally invasive treatment for hemorrhoids is ligation of hemorrhoids latex rings. Ligation technique is that through anoscope with lighter by vacuum or mechanical ligatora (Karl Storz, Germany) throw a latex ring for internal hemorrhoidal node, which is torn away, along with a latex ligature for 12-14 days. At the site of rejection haemorrhoid brand viagra shaped stump, covered by connective tissue. Possible to hold from 1 to 4-5 ligation with an interval between treatments 10-12 days. According to the results of our research, 73% of patients to achieve good results is required to hold two sessions of ligation. In 16% a good result can be obtained after a single session. In 11% of the observations to obtain a good result you want to conduct more than 3 procedures. All procedures are performed as outpatients. 89% of patients, regardless of stage of disease, there is complete relief of all symptoms.

Competing methods for the ligation sites latex rings is ligation of hemorrhoidal vessels under the control of an ultrasonic Doppler. This technique is used in vtoroytretey stage hemorrhoids. This new method allows us to accurately determine the location and number of terminal branches of the upper hemorrhoidal artery in the submucosal layer of the rectum using a specially designed anoscope equipped with utrazvukovym sensor. After the appearance of the sound pulse signal through a window in anoscope special needle with a polypropylene thread stitch hemorrhoidal vessel and bandage it. Termination of the audio signal indicates that the correct ligation of vessels. Simultaneously, stitch and bandage for 4 to 6 vessels. After ligation of the vessels occurs and wears zapustevanie hemorrhoids. If necessary, repeat the procedure is carried out through a 14-16 days. Technique quite effective, as evidenced by the good results obtained in 91% of patients with 2-3 stage hemorrhoids.

Conclusion

The choice of method of hemorrhoid treatment is determined by the stage and severity of symptoms. At the first stage, are highly effective drugs, as well as infrared photocoagulation and sclerotherapy for treatment. In the second stage of the disease are competing ways of sclerosing therapy treatment, ligation of hemorrhoids latex rings or suturing and bandaging of the terminal branches of hemorrhoidal artery under the control of an ultrasonic Doppler. At the third stage, are highly effective hemorrhoids last two methods. At the fourth stage of the disease-invasive techniques can be applied only in the presence of severe disease, preventing the fulfillment of traditional hemorrhoidectomy. In acute hemorrhoid treatment of choice is medical therapy with analgesics, flebotropnyh and local products. Note that if the conservative treatment of acute and chronic hemorrhoids can be performed by general practitioners, the minimally invasive techniques should be performed only by physician-Coloproctologists on an outpatient basis, or on the testimony - in the hospital.

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