Результати лікування хронічного геморою І — ІІ ступеня з використанням методу біполярної вапоризації

Minimally invasive methods for the treatment of chronic hemorrhoids are a crucial component of modern proctology. However, they do not always provide optimal outcomes due to recurrences, complications, and the need for repeat procedures. Some methods have limited accessibility due to high requirements for physician expertise and expensive equipment, highlighting the need for improved approaches. Objective — to evaluate the efficacy and safety of bipolar vaporization for treating grades I—II chronic hemorrhoids. Materials and methods. The study included 32 patients (19 men and 13 women) aged from 19 to 70 years with chronic hemorrhoids of grades I—II that were resistant to conservative treatment. The duration of chronic hemorrhoids ranged from 1 to 20 years, with an average of 6.8±4.5 years. The bipolar vaporization procedure was performed using the Ukrainian‑made bio‑welding generator EK‑300M «Sarmed.» The primary endpoints included assessment of hemorrhoid symptoms, complications, patient satisfaction with treatment outcomes, and recurrence rates. Results. Persistent bleeding and/or node thrombosis were the primary indications for surgery in 100% of patients, affecting 14 patients (43.8%). Intraoperative blood loss did not exceed 20 ml, with an average of 8.3±3.7 ml. The mean duration of the procedure was 44.3±7.1 minutes. The average number of ketorolac doses on the first postoperative day was 1.4±0.9 doses (ranging from 1 to 4 doses), and on the second day, 1.8±0.8 doses (ranging from 1 to 3 doses). The mean hospital stay was 2.3±0.5 days (2 to 3 days), and the average period of incapacity for work was 5.8±0.7 days (5 to 7 days). On the 7th postoperative day, 65.6% of patients reported pain, but its intensity was low (1.62±0.7 points, p=0.003). At 6 weeks and 1 year postoperatively, none of the patients reported pain. After one year, 96.9% of patients were free of prolapse, itching, or soiling, and bleeding was absent in all cases. Patient satisfaction after one year averaged 8.31±0.74 points. Recurrence occurred in 3.1% of patients. Conclusions. Bipolar vaporization is an effective and safe method for treating chronic hemorrhoids of grades I—II, providing significant symptom relief, minimal blood loss, and a short recovery period. The method demonstrates a high level of patient satisfaction and a low recurrence rate. The study results confirm the high efficacy and safety of this method, making it a promising approach for the treatment of chronic hemorrhoids.