IS THERE A PLACE FOR HIGH-RESOLUTION ANOSCOPY IN THE DIAGNOSTICS OF INFLAMMATORY CHANGES IN PATIENTS WITH CHRONIC HEMORRHOIDS?

Abstract

AIM: to evaluate the significance of high-resolution anoscopy (HRA) in diagnostics of inflammatory and thrombotic changes in hemorrhoid piles and to assess the efficacy of micronized purified favonoid fraction (MPFF) in patients with inflammatory thrombotic changes of hemorrhoids according to HRA results in the preoperative conservative treatment of hemorrhoids. PATIENTS AND METHODS: a prospective cohort study included 77 patients with grade III chronic hemorrhoids. Patients were divided into 3 groups depending on the degree of development of inflammatory and thrombotic changes according to the HRA. The 3 group included patients with preoperative conservative treatment by MPFF. All patients underwent Milligan-Morgan procedure with further histological study of removed piles. RESULTS: it was found that the diagnostic sensitivity of the HRA in detection of inflammatory thrombotic changes was 91.3 % (CI=83.6-96.2 %), and diagnostic specificity - 40 % (CI=19-64 %). HRA diagnostic accuracy was 82.1 % (p=0.001). A 30 % decrease in the number of removed piles with moderate inflammatory thrombotic changes after MOFF therapy has also been revealed. CONCLUSION: HRA permits to determine the severity of thrombotic inflammatory changes, which is extremely importantfor the management of patients with acute hemorrhoids.