Deleting, fixing, or dearterizing nodes? In search of optimal pathogenetic treatment for hemorrhoid disease

DOI: https://doi.org/10.29296/25877305-2021-03-03
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Issue: 
3
Year: 
2021

M. Popovtsev; Professor A. Alekberzade, MD; Professor N. Krylov, MD I.M. Sechenov First Moscow
State Medical University (Sechenov University) , Ministry of Health of Russia

The literature review provides information about the principles of radical pathogenetic treatment for hemorrhoid disease (HD), the emergence and further development of donor techniques that have served as the basis for developing the hemorrhoidal artery ligation and rectoanal (HAL-RAR) technology; and analyzes the reasons for its effectiveness due to the combination of two different approaches that have evolved independently of one another until a certain moment. The combination of these techniques has been incentive to a technological breakthrough in the treatment of HD and to the better quality of life in patients after surgical treatment. HAL-RAR has proven to be a highly effective and safe technique for the surgical treatment of HD. The relatively rare failures that occur after the HAL-RAR technology and lead to the need for resection procedures in the future do not reduce its popularity. One of the main advantages of this technology is the simplicity of its technical execution and minimal requirements for the skill and experience of the operator. Another important feature may be considered to be the ability to adapt the HAL-RAR technology for use in both outpatient settings and day hospitals without the need for long-term medical observation of patients.
Keywords: 
coloproctology
surgery
hemorrhoid disease
hemorrhoidectomy
desarterization of internal hemorrhoidal nodes
lifting of internal hemorrhoidal nodes
HAL-RAR technology

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