Comparative analysis of the results of treatment of trans- and suprasphincteric anal fistulae by thermo-obliteration of fistula track with diode laser or monopolar electrocoagulation

Костарев, И. В.; Kiselev, D. O.; Благодарный, Л. А.; Жарков, Е. Е.; Титов, А. Ю.; Болквадзе, Э. Э.; Мудров, А. А.; Матинян, А. В.

doi:10.24884/0042-4625-2020-179-4-36-43

VESTNIK KHIRURGII IMENI I.I.GREKOVA

2020

DOI: 10.24884/0042-4625-2020-179-4-36-43

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Comparative analysis of the results of treatment of trans- and suprasphincteric anal fistulae by thermo-obliteration of fistula track with diode laser or monopolar electrocoagulation

И. В. Костарев

D. O. Kiselev

Л. А. Благодарный

et al.

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Cited by 5 publications

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The role of laser technologies in coloproctology

Torchua¹,

Абрицова²,

Matinyan³

2023

Ambulatornaya khirurgiya

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Laser (Light Amplification by the Stimulated Emission of Radiation) is a technical device that emits electromagnetic radiation focused in the form of a beam in the range from infrared to ultraviolet, with high energy and biological effect. In the first quarter of the 20th century, A. Einstein laid the foundation for its creation, believing that when atoms are excited from an external radiation source, a multiple increase in the released photons occurs, and the result of this process is recorded as light energy. Back in the late twentieth century, lasers in coloproctology were used as a scalpel, in fact, they performed traditional surgical interventions, but using energy tools, however, this did not deprive patients of extensive wounds and, as a result, pronounced pain sensations. The modern use of laser in proctology is really minimally invasive. An optical fiber is carried through small punctures on the skin or fistula, through which the laser energy flows directly to the target and acts aiming. In coloproctology, lasers are used to treat hemorrhoidal disease, rectal fistulas and pilonidal sinus this isrecorded in clinical guidelines. The use of laser treatment with these nosologies can reduce the severity of pain after surgery, significantly reduce the healing time of wounds, shorten the period of disability, without reducing the quality of life of patients. At the same time, these interventions are almost as effective as classical operations, in some cases even superior. But despite these encouraging data, it is necessary to conduct further research in order to develop clear technical regulations for the use of laser techniques and tracking long-term results.

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The role of laser technologies in coloproctology

Torchua¹,

Абрицова²,

Matinyan³

2023

Ambulatornaya khirurgiya

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Laser Application for Diseases of the Anorectal Region

Frolov,

Kuzminov,

Vyshegorodtsev

et al. 2024

Rossijskij žurnal gastroènterologii, gepatologii, koloproktolog

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Aim: to summarize the literature data of use of laser technologies in the treatment of anorectal diseases. Key points. Lazer intervention technologies in the treatment of anorectal diseases such as haemorrhoids, anal fistula, anal fissure and pilonidal disease makes it possible to significantly reduce the intensity of pain syndrome, shorten the time of wound healing and also reduce the duration of the period of disability of the patient without worsening the quality of life. The main advantages of minimally invasive techniques are the absence of extensive wounds, minimal complications and reduction of the disease recurrence rate, minimally invasive methods are almost as effective as traditional ones. Besides, the use of laser allows to perform minimally invasive interventions under local anaesthesia in a day hospital. Conclusion. It is necessary to further study and improve the use of laser technologies in the treatment of anorectal diseases, and to actively introduce techniques into practice to improve the results of treatment of patients with these nosologies.

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Impact of the method of internal opening closure of anal fistula on outcomes after laser fistula coagulation. Preliminary results of randomized clinical trial

et al. 2022

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ЦЕЛЬ ИССЛЕДОВАНИЯ: предварительная оценка результатов хирургического лечения пациентов с транссфинктерными свищами прямой кишки с использованием лазерной коагуляции в зависимости от способа закрытия внутреннего свищевого отверстия. ПАЦИЕНТЫ И МЕТОДЫ: в проспективное рандомизированное одноцентровое сравнительное исследование включено 42 пациента с транссфинктерными свищами прямой кишки. В анализ результатов было включено 36 (85,7%) пациентов, у которых период наблюдения после операции превысил 3 месяца. 19 пациентов были рандомизированы в группу лазерной термокоагуляции свищевого хода в сочетании с его перевязкой в межсфинктерном пространстве (ЛТ + ПСМП), 17 -в группу лазерной термокоагуляции свища с пластикой внутреннего свищевого отверстия слизисто-мышечным лоскутом (ЛТ + СМЛ). Средний возраст пациентов -38 (26-70) лет. Мужчин -26, женщин -10. Средний период наблюдения за пациентами составил 6,5 месяцев. В периоперационном периоде (до операции, через 1 и 2 месяца после вмешательства) пациентам выполнялся УЗ-мониторинг для оценки процесса заживления свищей и раннего выявления рецидивов заболевания. РЕЗУЛЬТАТЫ: в группе ЛТ + ПСМП заживление свища отмечено у 17/19 (89,5%) пациентов, в группе ЛТ + СМЛ -у 11/17 (64,7%) пациентов (р = 0,113). Осложнений во время операции и ближайшем послеоперационном периоде не отмечено ни в одном случае. УЗ-мониторинг позволил объективно констатировать заживление или ранний рецидив свища при плановых обследованиях пациентов в послеоперационном периоде, что также соответствовало клинической картине. Наличие факторов, влияющих на рецидив заболевания на данном этапе исследования, выявлено не было. ЗАКЛЮЧЕНИЕ: при оценке предварительных результатов исследования ЛТ + ПСМП показала лучшие результаты по сравнению с методикой ЛТ + СМЛ. Однако требуется дальнейший набор пациентов в группы исследования с оценкой результатов в более отдаленном периоде.

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Comparative analysis of the results of treatment of trans- and suprasphincteric anal fistulae by thermo-obliteration of fistula track with diode laser or monopolar electrocoagulation

Cited by 5 publications

References 5 publications

The role of laser technologies in coloproctology

The role of laser technologies in coloproctology

Laser Application for Diseases of the Anorectal Region

Impact of the method of internal opening closure of anal fistula on outcomes after laser fistula coagulation. Preliminary results of randomized clinical trial

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