Comparative Analysis of Conventional and Minimally Invasive Techniques in the Treatment of Hemorrhoidal Disease: Outcomes and Therapeutic Effectiveness
DOI:
https://doi.org/10.14748/6jwsks29Keywords:
hemorrhoids, hemorrhoidectomy, THD, PPH, ligation, minimally invasive procedures, proctologyAbstract
Introduction: Hemorrhoidal disease (HD) remains one of the leading causes of proctologic consultations, with a wide range of therapeutic approaches, from conservative management to surgical intervention. In recent decades, there has been increasing interest in minimally invasive techniques, which promise less postoperative pain and faster recovery.
Aim: This report presents a comparative analysis of conventional surgical techniques (such as Milligan-Morgan and Whitehead hemorrhoidectomy) and minimally invasive procedures, such as transanal hemorrhoidal dearterialization (THD) and hemorrhoidal artery ligation with rectoanal repair (HAL-RAR), with a focus on therapeutic effectiveness, complications, postoperative pain, and recovery time.
Materials and Methods: A retrospective study was conducted at the Clinic of General and Hepatopancreatic Surgery (First Surgery) of Alexandrovska University Hospital over a 7-year period. A total of 219 patients were included, divided into two main groups—conventional and minimally invasive procedures.
Results: Minimally invasive methods demonstrated significantly shorter hospital stay, lower pain scores in the early postoperative period, and faster recovery. However, a higher recurrence rate was observed compared to classic hemorrhoidectomy techniques. Transanal hemorrhoidal dearterialization and HAL-RAR showed a favorable balance between effectiveness and patient comfort, especially in stage II–III disease.
Conclusion: The optimal approach to hemorrhoidal disease should be individualized. Minimally invasive techniques represent a valuable alternative in selected cases, while classical surgery remains the treatment of choice in advanced stages. A combined set of criteria for technique selection leads to the best clinical outcomes.
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