Comparative characteristics of the results of surgical treatment of combined anorectal pathology using modern radiosurgical and high-frequency electrosurgical technologies

Abstract

Annotation. Surgery of combined anal canal and rectal diseases requires an unconventional tactics and methods of treatment of these pathologies, which provide minimal impact on tissues, preventing postoperative complications. The purpose of the study was conduction a comparative evaluation of the results of surgical treatment of combined anorectal pathology using modern radiosurgery and electrosurgery technologies by analyzing the clinical course of the postoperative period and studying the depth of impact of these technological devices on the structure of operated tissues. The results of treatment of 635 patients with combined diseases of the anal canal and rectum, divided into four study groups, were analyzed. The control group consisted of 112 patients operated with a surgical scalpel. After surgery 30 patients from each study group underwent morphological investigation of rectal and anal tissues for measurement of the thickness of thermal impacts on them, which was performed using an eyepiece-micrometer scale. Statistical analysis of the obtained data was performed using IBM SPSS STATISTICS SUBSCRIPTIONAL TRIAL software. License number: L-CZAA-BHG85V. The following are used in the work: Kolmogorov-Smirnov test with Lilliefors and Shapiro-Wilk correction, Levene's criterion at p<0.05; applied one-way analysis of variance, Bonferroni test; used the Welch test and the Brown-Forsyth test, the Games-Howell test; used the Kruskal-Wallis test, the Mann-Whitney test. It is established that due to the minimal and shallow impact on the tissues during application of electrosurgery devices “KLS Martin”, “EFA” and “ERBE ICC 200”, as well as radiosurgery device “Surgitron”, there were no detected neither scar anal strictures in any of the four study groups nor scarring deformities of the pararectal areas, which contributed to the cosmetic nature of the combined operations and caused rapid rehabilitation of patients in the study groups. In the control group in 2 (1,8%) patients diagnosed the formation of scar anal stricture which required conservative (1 patient) and operative (1 patient) measures to eliminate them. Using of modern radiosurgical and electrosurgical technologies for the treatment of combined anal and rectal diseases reduces the duration of surgery, intraoperative blood loss, postoperative pain and prevents scar strictures of the anal canal.

Electrocautery ablation therapy for anal intraepithelial carcinoma: A study protocol

“…This device offers precise ablation of the targeted area and minimizes postprocedural pain. [ 14 , 15 ] When lesions are extensive, staged ablations are allowed at the physician’s discretion. The second procedure will usually be performed within 3 months.…”

“…Surgitron, is a popular medical device used for tonsillectomy, eye disease, and anorectal diseases. [12][13][14][15] The device provides a high radio frequency for precise ablation that is effective only for targeted lesions and minimizes unintended invasion, leading to few side effects. However, there have been no studies on the treatment of HSIL using this device.…”