ĐÁNH GIÁ KẾT QUẢ ĐIỀU TRỊ TRĨ VÒNG HỖN HỢP ĐỘ IV BẰNG PHẪU THUẬT WHITEHEAD TẠI BỆNH VIỆN TRUNG ƯƠNG QUÂN ĐỘI 108

Abstract

Whitehead surgery is considered a suitable method to treat grade IV mixed-ring hemorrhoids, but the rate of complications is still high. Nowadays, the development of vessel sealing devices helps to limit the disadvantages of Whitehead surgery. The study was carried out with the objective: To evaluate the results of treatment of grade IV mixed ring hemorrhoids by Whitehead surgery at 108 Central Military Hospital. Subjects and methods: Prospective descriptive study of 55 patients with grade IV mixed ring hemorrhoids treated by Whitehead surgery using Ligasure or pestle at the Department of Anal - Rectal and Pelvic Floor - 108 Central Military Hospital Results: The average age of patients was 52.6 years old, males accounted for 72.7%. The mean duration of illness was 83.4 months. 34 patients (61.8%) underwent whitehead surgery using a Ligasure vessel sealing device and 21 patients (38.2%) used a homemade pestle. The amount of blood loss, surgery time, and postoperative pain of the group using Ligasure was shorter than that of using the pestle (p < 0.05). Early complications 27.3%. The average follow-up time was 15.4 months, late complications were 7.3%, no recurrence. 98.8% had complete anal autonomy at the end of the study. Conclusion: Whitehead's hemorrhoidectomy is an effective method in the treatment of grade IV mixed ring hemorrhoids with a low rate of complications and recurrence. The application of Whitehead's hemorrhoidectomy with supporting instruments or vessel sealing devices depends on the surgeon's habits.