2020年12月29日星期二

are hemorrhoids hard,Explain again "laser treatment of hemorrhoids"

    In the domestic and foreign medical literature database, "laser treatment of hemorrhoids", recent new literature is rare.

    However, friends have been consulting, and some medical institutions have carried out laser treatment of hemorrhoids.

    The continuous development of laser medicine also gives us hope for the application of laser in anorectal surgery.

    After all, minimally invasive or non-invasive, reducing normal anal canal tissue damage, and rapid and painless recovery are the highest level pursued by anorectal surgery.

    Laser is a beam of strong light generated by excitation of a substance, and it is widely used in medicine. The monochromaticity and directionality of the laser enable the diameter of the treatment area to be as small as micrometers, and the damaged lesions can be accurately selected without affecting the surrounding normal tissues. The high-brightness characteristics of the laser make the focused spot of the laser have a high energy density and shorten the operation time. Laser knife surgery is not easy to cause infection, there is less bleeding during the operation, and the postoperative recovery is quick.

    The applications of laser in clinical medicine are: (1) Cutting and separating. When removing tumors, the laser beam can quickly separate the tissue. (2) Gasification and melting. When the light spot irradiation area reaches a high temperature of more than 200 degrees and has a certain pressure, the local tissue will be gasified and melted, and it is aimed at benign and small tumors. (3) Cauterization to stop bleeding. Treat recurrent intractable epistaxis. (4) Solidification and sealing. Retina welding is possible. (5) Defocused irradiation. Extend the laser beam into a large spot to irradiate the diseased part to prevent inflammation, relieve itching, analgesia, and reduce swelling. (6) Acupoint irradiation. Irradiating acupoints with laser, giving acupoint stimulation while inputting energy, has the effect of acupuncture.

    The most commonly used surgical lasers are carbon dioxide laser, argon laser, and neodymium: yttrium aluminum garnet laser (Nd: YAG). These three lasers with different wavelengths will produce specific tissue effects and have different surgical applications. Carbon dioxide laser is mainly used for cutting. Argon laser has a good coagulation effect on surface blood vessels, while non-contact Nd: YAG laser is used for coagulation of deep blood vessels. It can be used for surgical operations of various endoscopic instruments through optical fibers.

    In anorectal surgery, a low-power He-Ne laser will be used to irradiate the wound after surgery to enhance the body's defense and immunity, strengthen the phagocytic function of white blood cells, increase immunoglobulin, improve blood vessel regeneration, anti-inflammatory, and promote wound healing.

    Anorectal surgery, using Nd: YAG laser or carbon dioxide laser for hemorrhoidectomy, the biological effect of carbon dioxide laser is predictable, the damage to adjacent normal tissues is small, the hemostatic effect is good, and the operation is accurate.

    Laser treatment of hemorrhoids requires the use of narcotic analgesics after surgery. The wound usually heals in about a month.

    Some scholars believe that there is no advantage in the use of laser therapy in the treatment of hemorrhoids from stage 3 to stage 4.

    Some randomized controlled studies have shown that there is no difference between traditional hemorrhoidectomy such as scalpel and contact Nd:YAG laser treatment of hemorrhoids in terms of hospital stay, catheterization requirements, operation time, intraoperative blood loss and the application of analgesics. The healing time of the two is similar. Laser treatment of hemorrhoids can also cause anal stenosis, and the incidence of early and late complications is not significantly different from that of traditional surgical hemorrhoidectomy. Laser treatment has a higher incidence of inflammation and wound dehiscence, and the cost of laser treatment is higher.

    Therefore, the effectiveness or advancement and uniqueness of laser treatment of hemorrhoids have not been supported by research.

    At present, anorectal surgery also uses HCPT (High Frequency Capacitance Field), Ligasure Vessel Closure System, electrosurgical knife, bipolar electrocoagulation scissors, ultrasonic knife and other energy instruments. But you must understand that these are just tools. Using a lancet or scissors, the doctor should be able to cut hemorrhoid tissue more accurately and accurately. Which tool is handy, less traumatic, and less impact on tissue recovery. Which one to use is the greatest responsibility to the patient.

    Although there is no new development in the application of laser technology in anorectal medicine, laser cytology, laser human physiology, laser diagnostics, laser therapy, medical laser technology, laser protection, and molecular biological laser engineering are still fast Development, laser technology will be more widely used in various clinical departments.

    Therefore, in order to provide patients with better medical technology, our anorectal department will continue to study better methods of laser application in clinical work, and strive to minimize the occurrence of trauma in the treatment of anorectal diseases.

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