Materials and methods
1. Object inclusion criteria
(1) by the Chinese Medical Association branch of anorectal surgery Surgery Group in2004 developed sub-degree hemorrhoids diagnostic criteria were diagnosed as III-degreehemorrhoids;
(2) preoperative incontinence score are 0 sub-persons;
(3) to exclude themerger has anal stenosis, anal fissure, anal anal diseases, sinusitis and other persons; (4)ruled out surgery and a history of injection therapy;
(5) to exclude those with seriouscomplications (such as severe cardiovascular and cerebrovascular disease, blood disease).
2. Selected object
86 patients were selected, two groups of patients before hemorrhoids prolapse duringdefecation were required to hand is also satisfied. Hemorrhoids were randomly dividedinto two semi-conductor laser coagulation group of 46 cases, male 26 cases and 20 female,aged 20-68 (average 37) years of age; Closed hemorrhoidectomy group of 40 patients,male 22 cases, female 18 cases, age 22-67 (average 41) years old.
3. laser and optical fibers
810nm, 30W diode laser, 600-micron fiber, the fiber end of the 5mm jacket layercurettage, to avoid the hot melt solidification coat layer.
4. surgery methods
1) Diode laser coagulation hemorrhoid surgery: spinal anesthesia using pronejackknife position, in the buttocks wide tape affixed to both sides of the sutureand fixation on the operating table edge, exposed operative field. PSA33 analpurse-string suture with the use of mirrors revealed hemorrhoids
A.In hemorrhoids skin at the lateral margin of anal tube with the needle 18 into the hemorrhoids. Exit needle core, ascending into 600um fiber, placedin the central hemorrhoids, and then withdraw trocar. Open the laser treatment device, set the transmit power of 3W, each pulse time of 1S.,Interval time set to 1S.. Laser fiber and laser treatment instrument connected,open the light source, we can see the red light directed through the hemorrhoidalmucosa, so that the overall permeability hemorrhoids, showing bright red. Afterthe launch of laser can be seen gradually shrink hemorrhoids, direct light is alsogradually being interdictions to be hemorrhoids as a whole can no longer be likethe end of treatment was transparent. Based on the size of hemorrhoids, hemorrhoids can be of optical fiber in a central location up and down and movearound, line multi-point solidification, the solidification time for each ofhemorrhoids 60-120S. Treatment with the rest of hemorrhoids, surgerycompleted only in the anal margin of left puncture marks on non-surgical wounds,surgery without the use of antibiotics.
2) Closed hemorrhoidectomy: Compliance routine surgical operation
Conclusion:
Diode laser wavelength is 810nm, there is a better role in the solidification and gasification. Meanwhile, the deoxy-hemoglobin absorption of 810nm wavelength laser, the highest rate, so the diode laser has a good hemostatic effect. Diode laser temperature curve steep, that is, the penetration depth of laser light, the surrounding deep tissue safer.Studies have confirmed that endovenous laser treatment in the peak temperature oftreatment area will not cause permanent heat damage outside the organization. Take advantage of this feature to avoid surgery anal sphincter damage the thermal coagulation.
Accordingly, through the fiber hemorrhoids in diode laser irradiation, selectively makehemorrhoids venous plexus and the surrounding tissue coagulation degeneration, fibrosis,vascular occlusion to make hemorrhoids, hemorrhoids shrinking fixed, the purpose ofcorrecting prolapsed hemorrhoids.
Diode laser coagulation hemorrhoids and hemorrhoidectomy is different in the treatment of hemorrhoids when you only to insert thin laser fiber, the use of the laser characteristics make hemorrhoidal venous plexus and surrounding tissue coagulation variability, withoutany incision and excision method is simple and , trauma, postoperative pain and thereforea minor. In addition, the removal of anal cushions for failing organization, they can be used to maximize the protection of anal function. The technology is also different from sclerotherapy, as sclerotherapy, and not directly to the expansion of the hemorrhoidal venous plexus degeneration of occlusion, it may be easy to relapse after treatmenthardening agent one of the reasons.
donna@gigaalaser.com
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