THE AIM of the study was to develop a minimally invasive technique that does not have the disadvantages of traditional surgical treatment, does not have any restrictions in patients with external hemorrhoids as in HAL-RAR method. Technique that is more effective than HAL-RAR and isolated laser destruction methods, in the treatment of patients with chronic hemorrhoids stage II-III. MATERIALS AND METHODS. We developed a combined method of treatment of the patients with hemorrhoids, that unites artery ligation under the ultrasound control with Doppler effect and submucous subdermal laser destruction of internal and external hemorrhoids. We studied the safetiy and effectiveness of the developed method. The study included 100 patients with chronic hemorrhoids stage II and III, the patients were treated with the use of combined methodology HAL-laser (study group), the method HAL-RAR (1 control group) and closed hemorrhoidectomy linear stapler (control group 2). RESULTS. The analysis showed that the combined method HAL-laser has higher efficiency than the method HAL-RAR, and thus is as safe and well tolerated in patients. Its not so efficient compare to conventional hemorrhoidectomy because of the risk of a cosmetic defect, but does not increase the risk of recurrence of the disease, reduces the risk of complications and more endurable for the patients, it also allows to reduce the time of disability.

Combined method overcomes the drawbacks of traditional surgical treatment and limitations in external components elimination which are inherent for HAL-RAR. Moreover, it has a higher efficiency in treating of hemorrhoids stage II-III compared with HAL-RAR and is equally safe and well tolerable for patients. This method does not increase the risk of recurrence, reduces incidence of complications and time of disability.

Currently, the post-surgical rehabilitation of patients with hemorrhoidal disease is a serious medical and social problem. The authors proposed a comprehensive method of the management of hemorrhoids, combining seam artery ligation under Doppler ultrasound control with subdermal-submucous laser destruction of internal and external hemorrhoids. There was executed the comparative study of the safety and efficiency of both this method and the closed hemorrhoidectomy, with the use of linear stapler, in patients with chronic hemorrhoids at the stage II and III. The combined method of HAL + laser was shown to be potent of both improving the quality of life for patients during the rehabilitation period and significantly diminishing its duration. This method eliminates the risk of wound complications, reduces the risk of urinary retention by 7 times, and significantly relief from the pronounced pain in the postoperative period.

Short bowel syndrome is a severe, rare malabsorption disorder, often resulting from extensive surgical resections of the small intestine. This condition is often accompanied by pronounced violations of the nutritional status and fluid and electrolyte balance, which are poorly amenable to drug correction. In this article, we describe three clinical cases of patients suffering from this pathology where it was possible to achieve pronounced clinical improvement through reconstructive surgery.