Optimization of treatment tactics in the postoperative period after hemorrhoidectomy

Annotation. Despite the advancement of minimally invasive techniques, hemorrhoidectomy remains the gold standard for the treatment of stage III-IV hemorrhoids. However, the postoperative period following hemorrhoidectomy is often associated with significant pain, tissue edema, and prolonged wound healing, which substantially impact patients’ quality of life and extend the duration of disability. The combination of streptokinase and streptodornase enzymes possesses unique properties that may be beneficial in the postoperative period. The aim of this study was to evaluate the efficacy and safety of adjunctive use of streptokinase-streptodornase suppositories in the comprehensive treatment of patients following hemorrhoidectomy compared to standard therapy. The study included 45 patients who underwent surgery for chronic hemorrhoids. The control group (n=22) included patients receiving standard postoperative therapy, while the experimental group (n=23) additionally received streptokinase-streptodornase rectal suppositories for 7 days. Treatment outcomes were assessed based on the duration of hospitalization, intensity of pain syndrome, frequency of complications, rate of wound epithelialization, need for additional analgesia, time to first bowel movement, and patient satisfaction with treatment. The obtained data were processed using the statistical software package SPSS 20.0 for Windows. The adjunctive use of streptokinase-streptodornase suppositories in the postoperative period following hemorrhoidectomy significantly reduced the duration of hospitalization, the incidence of severe postoperative complications, and accelerated the epithelialization of postoperative wounds, while also providing a pronounced analgesic effect. Streptokinase-streptodornase demonstrated good tolerability and safety with rectal administration, without causing serious adverse effects.