BAVOSILNI DAVOLASHDA ZAMONAVIY JARROHLIK TEXNIKALAR VA ULARNING SAMARADORLIGINI BAHOLASH

Oktyabr Teshayev

Tibbiyot fanlari doktori, Oilaviy tibbiyotda xirurgik kasalliklar kafedrasining professori, Toshkent Davlat Tibbiyot Universiteti (TDTU), Toshkent, O‘zbekiston.

Alijon Murodov

Tibbiyot fanlari doktori, Oila tibbiyotda xirurgik kasalliklar kafedrasining xodimi, Toshkent Davlat Tibbiyot Universiteti (TDTU), Toshkent, O‘zbekiston.

Azima Shermamatova

Oila tibbiyotida xirurgik kasalliklar kafedrasining 2-bosqich talabasi, Toshkent Davlat Tibbiyot Universiteti (TDTU), Toshkent, O‘zbekiston.

Keywords: gemorroidektomiya, lazer gemorroidektomiya, stapled gemorroidopeksiya, THD, embolizatsiya, samaradorlik bahosi, minimal invaziv usullar, asoratlar, tiklanish muddati, meta-tahlil, epidemiologiya, etiopatogenez, klinik belgilari, anatomiya, etiopatogenez, diagnostika, konservativ davolash, klinik tadqiqotlar, meta-tahlillar, hayot sifati, iqtisodiy tahlil, kelajak yo'nalishlari.

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Abstract

Bavosil kasalligi (gemorroy) dunyo bo'ylab keng tarqalgan proktologik kasallik bo'lib, uning davolashida zamonaviy jarrohlik texnikalari muhim o'rin egallaydi. Ushbu maqola bavosilni davolashda qo'llaniladigan zamonaviy jarrohlik usullari, jumladan, klassik gemorroidektomiya, lazer gemorroidektomiya (LHP), stapled gemorroidopeksiya (PPH), transanal gemorroidal dearterializatsiya (THD), embolizatsiya va boshqa minimal invaziv texnikalarning samaradorligini baholashga bag'ishlangan. Ilmiy adabiyotlarning tizimli tahlili va meta-tahlillar asosida ushbu usullarning afzalliklari, kamchiliklari, qaytalanish darajasi, asoratlar (masalan, qon ketishi, infeksiya, og'riq), bemorlarning tiklanish muddati, operatsiya muddati va hayot sifati ko'rsatkichlarini solishtirish ko'rib chiqiladi. Natijalar shuni ko'rsatadiki, minimal invaziv usullar an'anaviy jarrohlikka nisbatan og'riqni 50% gacha kamaytiradi va tiklanishni 1-2 haftaga tezlashtiradi, ammo uzoq muddatli samaradorlikda klassik usullar ustunlik qiladi. Masalan, 2025 yilgi meta-tahlillarda THD va LHP usullari 90% dan yuqori samaradorlikka ega ekanligi ta'kidlangan. Maqola PubMed, PMC, Springer va boshqa yuqori saviyali bazalardan olingan 60 dan ortiq ilmiy manbalar asosida tuzilgan bo'lib, mavzuning ilmiy dolzarbligini yuqori darajada yoritadi, chunki bavosil global sog'liqni saqlash tizimida yillik millionlab dollarni sarflaydigan muammo hisoblanadi. Ushbu tahlil orqali klinisyenlar uchun optimal davolash strategiyalarini tanlash bo'yicha tavsiyalar beriladi. Bundan tashqari, maqola mavzuning ko'p qirraliligini ko'rib chiqadi, shu jumladan, kasallikning epidemiologik jihatlari, anatomik xususiyatlari, etiopatogenezi va klinik belgilari batafsil tahlil etiladi. Zamonaviy texnikalarning rivojlanishi, ularning klinik sinovlari va bemorlarning hayot sifatiga ta'siri keng yoritiladi, bu esa mavzuning ilmiy va amaliy ahamiyatini oshiradi. Maqola shuningdek, kelajakdagi tadqiqot yo'nalishlarini belgilab, robotik jarrohlik va sun'iy intellektning potensialini muhokama qiladi, chunki bu texnologiyalar davolash samaradorligini yanada oshirishi mumkin. Umuman olganda, ushbu ish bavosil kasalligini davolash sohasidagi zamonaviy yondashuvlarni tizimli ravishda baholashga qaratilgan bo'lib, klinik amaliyot uchun qimmatli ma'lumotlarni taqdim etadi.

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References

1. Quan, L., Bai, X., Cheng, F., Chen, J., Ma, H., Wang, P., Yao, L., Bei, S., & Jia, X. (2025). Comparison of efficacy and safety between surgical and conservative treatments for hemorrhoids: a meta-analysis. BMC Gastroenterology, 25(1), 492. https://doi.org/10.1186/s12876-025-04089-2

2. Hawkins, A. T., Davis, B. R., Bhama, A. R., Fang, S. H., Dawes, A. J., Feingold, D. L., Lightner, A. L., & Paquette, I. M. (2024). The ASCRS clinical practice guidelines for the management of hemorrhoids. Diseases of the Colon & Rectum, 67(5), 614-623. https://doi.org/10.1097/DCR.0000000000003276

3. Cengiz, T. B., & Gorgun, E. (2019). Hemorrhoids: The definitive guide to medical and surgical treatment. Cleveland Clinic Journal of Medicine, 86(9), 612-620. https://consultqd.clevelandclinic.org/hemorrhoids-the-definitive-guide-to-medical-and-surgical-treatment

4. Rivadeneira, D. E., Steele, S. R., Ternent, C., Chalasani, S., Buie, W. D., & Rafferty, J. L. (2018). Hemorrhoids: Diagnosis and treatment options. American Family Physician, 97(3), 172-179.

5. Yang, J., Cui, P. J., Han, H. Z., & Tong, D. N. (2013). Meta-analysis of randomized controlled trials comparing outcomes for stapled hemorrhoidopexy versus LigaSure hemorrhoidectomy for symptomatic hemorrhoids in adults. International Journal of Surgery. https://doi.org/10.1016/j.ijsu.2013.07.006

6. Lie, H., Caesarini, E. F., Purnama, A. A., & et al. (2022). Laser hemorrhoidoplasty for hemorrhoidal disease: a systematic review and meta-analysis. Lasers in Medical Science, 37(9), 3621-3630. https://doi.org/10.1007/s10103-022-03643-8

7. Tan, V. Z. Z., Peck, E. W., Sivarajah, S. S., Tan, W. J., Ho, L. M. L., Ng, J. L., Chong, C., Aw, D., Mainza, F., Foo, F. J., & Koh, F. H. (2022). Systematic review and meta-analysis of postoperative pain and symptoms control following laser haemorrhoidoplasty versus Milligan-Morgan haemorrhoidectomy for symptomatic haemorrhoids: a new standard. International Journal of Colorectal Disease, 37(8), 1759-1771. https://doi.org/10.1007/s00384-022-04225-4

8. Yosra Abduallah Elsayed Abu Omar, Rania Mohamed Al Ahmady, Hosam Sobhy Abd El-rehim, & Mohamed Ahmed Fouad El-shimy. (2024). Systematic review and meta-analysis of laser haemorrhoidectomy versus conventional surgical haemorrhoidectomy in management of II- and III-degree haemorrhoid. Ain-Shams Journal of Surgery, 17(2), 179-196. https://doi.org/10.21608/ASJS.2024.351451

9. Wee, I. J. Y., Koo, C. H., Seow-En, I., Ng, Y. Y. R., Lin, W., & Tan, E. J. K. W. (2023). Laser hemorrhoidoplasty versus conventional hemorrhoidectomy for grade II/III hemorrhoids: a systematic review and meta-analysis. Annals of Coloproctology, 39(1), 3-10. https://doi.org/10.3393/ac.2022.00598.0085

10. Wee, I. J. Y., Oo, Y., Seow, C. H., Lam, T. J., & Koh, F. H. (2024). A systematic review comparing the efficacy of 980 nm vs. 1470 nm wavelengths in laser hemorrhoidoplasty. International Journal of Colorectal Disease. https://doi.org/10.1007/s00384-024-04690-z

11. Chaouch, M. A., Gouader, A., Krimi, B., & Oweira, H. (2023). Comments on “Laser hemorrhoidoplasty versus conventional hemorrhoidectomy for grade II/III hemorrhoids: a systematic review and meta-analysis”. Annals of Coloproctology, 39(5), 442-443. https://doi.org/10.3393/ac.2023.00206.0029

12. Jin, L., Qin, K., Wu, R., Yang, H., Cui, C., Wang, Z., & Wu, J. (2024). Laser hemorrhoidoplasty vs. rubber band ligation: a randomized trial comparing 2 mini-invasive treatment for grade II hemorrhoids. BMC Surgery, 24, 164. https://doi.org/10.1186/s12893-024-02425-z

13. Lie, H., Caesarini, E. F., Purnama, A. A., & et al. (2022). Laser hemorrhoidoplasty for hemorrhoidal disease: a systematic review and meta-analysis. Lasers in Medical Science, 37, 3621-3630. https://doi.org/10.1007/s10103-022-03643-8

14. Salgueiro, P., Rei, A., Garrido, M., Rosa, B., Oliveira, A. M., Pereira-Guedes, T., Morais, S., & Castro-Poças, F. (2022). Polidocanol foam sclerotherapy in the treatment of hemorrhoidal disease in patients with bleeding disorders: a multicenter, prospective, cohort study. Techniques in Coloproctology, 26(8), 615-625. https://doi.org/10.1007/s10151-022-02600-5

15. Giannini, G., Giarratano, G., De Seta, V., Piccinini, A., Gasparini, G., & et al. (2025). Polidocanol foam sclerotherapy for hemorrhoidal disease: a systematic review and expert survey. Updates in Surgery. https://doi.org/10.1007/s13304-025-02258-2

16. Gallo, G., Dezi, A., Grossi, U., & Picciariello, A. (2023). Sclerotherapy with 3% polidocanol foam in the treatment of hemorrhoidal disease: unveiling the missing pieces for a comprehensive evaluation. Frontiers in Surgery, 10, 1344724. https://doi.org/10.3389/fsurg.2023.1344724

17. Gualtieri, G., Leo, P., Naldini, E., Trovato, M., De Simone, M., Lorenzon, R., Pucciarelli, F., & Pucciarelli, A. (2020). Short-Term Results of Sclerotherapy with 3% Polidocanol Foam for Symptomatic Second- and Third-Degree Hemorrhoidal Disease. Journal of Investigative Surgery, 33(8), 1059-1065. https://doi.org/10.1080/08941939.2020.1745964

18. Pata, F., Bracchitta, L. M., D’Ambrosio, G., & Bracchitta, S. (2022). Sclerobanding (Combined Rubber Band Ligation with 3% Polidocanol Foam Sclerotherapy) for the Treatment of Second- and Third-Degree Hemorrhoidal Disease: Feasibility and Short-Term Outcomes. Journal of Clinical Medicine, 11(1), 218. https://doi.org/10.3390/jcm11010218

19. Yang, J., Cui, P. J., Han, H. Z., & Tong, D. N. (2013). Meta-analysis of stapled hemorrhoidopexy vs LigaSure hemorrhoidectomy. World Journal of Gastroenterology, 19(29), 4799-4807. https://doi.org/10.3748/wjg.v19.i29.4799

20. Chen, Y. T., & et al. (2024). Stapled hemorrhoidopexy for hemorrhoids: A overview of systematic reviews and meta-analysis. Asian Journal of Surgery. https://doi.org/10.1016/j.asjsur.2024.06.006

21. Chen, Y. T., & et al. (2024). Stapled hemorrhoidopexy for hemorrhoids: A overview of systematic reviews and meta-analysis. Asian Journal of Surgery, S1015-9584(24)01223-5. https://doi.org/10.1016/j.asjsur.2024.06.006

22. Bashir, Y., Hussein Al-Awaysheh, M. M., Ain, Q. U., O'Connor, D., Mockler, D., & Eguare, E. (2022). Systematic Review & Meta-Analysis of Randomized Control Trials Comparing Stapled Hemorrhoidectomy versus Trans Anal Hemorrhoidal Dearterialization for Treatment of Hemorrhoidal Disease. Surgery, Gastroenterology and Oncology, 27(1), 1-12. https://doi.org/10.21614/sgo-416

23. Giordano, P., Gravante, G., Sorge, R., Ovens, P., & Nastro, P. (2008). Long-term outcomes of stapled hemorrhoidopexy vs conventional hemorrhoidectomy: a meta-analysis of randomized clinical trials. Archives of Surgery, 143(2), 226-232. https://doi.org/10.1001/archsurg.2007.40

24. Watson, A. J., Hudson, J., Wood, J., Kilonzo, M., Brown, S. R., McDonald, A., Norrie, J., Bruhn, H., & Cook, J. A. (2016). Comparison of stapled haemorrhoidopexy with traditional excisional surgery for haemorrhoidal disease (eTHoS): a pragmatic, multicentre, randomised controlled trial. The Lancet, 388(10058), 2375-2385. https://doi.org/10.1016/S0140-6736(16)31803-7

25. Kang, S. I. (2025). Latest research trends on the management of hemorrhoids. Journal of the Anus, Rectum and Colon, 9(2), 179-191. https://doi.org/10.23922/jarc.2024-090

26. Ambe, P. C., Martin-Martin, G. P., Vasas, N., Piponski, I., Roman, I. H., Hernandez, J. D. P., Ma, H., Lin, H. C., Weyand, G., Mazlan, L., García Flórez, L. J., Wolff, K., Dessily, M., Wang, C., Dobricanin, V., Yang, W., Bruketa, T., Zeng, X. D., Avdicausevic, S., Zhang, Z. G., Wais, S., Kalaskar, S., Cui, Z., Pestonit, I. B., Cao, Y. Q., Suárez Sánchez, A., Ren, D. L., Vargas Castillo, E., Zheng, D., Bogdanic, B., Wölk, A., Yao, Y., Issaad, S., Nasser, T., Guo, X. T., Nagar, M. M., Merkle, M., Ruiz-Lopez, M., Zhang, Y., Blumberg, C., Alam, A. A., Acosta, A. C., Schouten, R., Istok, P., Demtröder, C., Wang, Z. Y., Dong, Q., Wu, J., & The LHP Recommendation Development Group. (2024). Best clinical practice recommendations for the management of symptomatic hemorrhoids via laser hemorrhoidoplasty: the LHP recommendations. Techniques in Coloproctology, 29(1), 2. https://doi.org/10.1007/s10151-024-03022-1

27. Bilianskyi, L., & Voloshyn, I. (2025). Minimally invasive techniques in stage I–II chronic hemorrhoids: outcomes and prioritization. ЗХ, (2), 36-43. https://doi.org/10.30978/GS-2025-2-36

28. Quan, L., Bai, X., Cheng, F., Chen, J., Ma, H., Wang, P., Yao, L., Bei, S., & Jia, X. (2025). Comparison of efficacy and safety between surgical and conservative treatments for hemorrhoids: a meta-analysis. BMC Gastroenterology, 25, 492. https://doi.org/10.1186/s12876-025-04089-2

29. Jiang, T., Fan, L., Tang, X., Xu, Z., & Wu, W. (2025). Superselective superior rectal artery embolization in the treatment of hemorrhoidal disease. Frontiers in Medicine, 12, 1530981. https://doi.org/10.3389/fmed.2025.1530981

30. Mayo Clinic. (2025). Hemorrhoids - Diagnosis and treatment. Mayo Clinic, August 23, 2025. https://www.mayoclinic.org/diseases-conditions/hemorrhoids/diagnosis-treatment/drc-20360280

31. Miyamoto, H. (2023). Minimally Invasive Treatment for Advanced Hemorrhoids. Journal of the Anus, Rectum and Colon, 7(1), 8-16. https://doi.org/10.23922/jarc.2022-068

32. MacRae, H. M., & McLeod, R. S. (1997). Comparison of hemorrhoidal treatments: a meta-analysis. Canadian Journal of Surgery, 40(1), 14-17. https://doi.org/10.1503/cjs.40.1.14

33. Albuquerque, A. (2016). Rubber band ligation of hemorrhoids: A guide for complications. World Journal of Gastrointestinal Surgery, 8(9), 614-620. https://doi.org/10.4240/wjgs.v8.i9.614

34. Iyer, V. S. M., Shrier, I., & Gordon, P. H. (2004). Long-Term Outcome of Rubber Band Ligation for Symptomatic Primary and Recurrent Internal Hemorrhoids. Diseases of the Colon & Rectum, 47(9), 1364-1370. https://doi.org/10.1007/s10350-004-0591-2

35. Patel, J., McKechnie, T., Wu, K., & et al. (2023). HEmoRhoidal disease management with Band ligation versus polidocanol Sclerotherapy: a systematic review and meta-analysis (the HerBS Review). International Journal of Colorectal Disease, 38, 112. https://doi.org/10.1007/s00384-023-04394-w

36. van Oostendorp, J. Y., Dekker, L., van Dieren, S., Veldkamp, R., Bemelman, W. A., Han-Geurts, I. J. M., & on behalf of the HollAND Study Group. (2025). Comparison of Rubber Band Ligation and Hemorrhoidectomy in Patients With Symptomatic Hemorrhoids Grade III: A Multicenter, Open-Label, Randomized Controlled Noninferiority Trial. Diseases of the Colon & Rectum, 68(5), 572-583. https://doi.org/10.1097/DCR.0000000000003679

37. Salgueiro, P., Ramos, M. I., Castro-Poças, F., & Libânio, D. (2022). Office-Based Procedures in the Management of Hemorrhoidal Disease: A Systematic Review and Meta-Analysis. Digestive Diseases, 40(6), 826-837. https://doi.org/10.1159/000522171

38. Nienhuijs, S. W., & et al. (2010). Pain after conventional versus Ligasure haemorrhoidectomy. A meta-analysis. International Journal of Surgery, 8(4), 269-273. https://doi.org/10.1016/j.ijsu.2010.04.001

39. Dey, A. M., & Malik, V. K. (2021). LigaSure Hemorrhoidectomy and Current Guidelines on Large Hemorrhoids. Diseases of the Colon & Rectum, 64(6), e380. https://doi.org/10.1097/DCR.0000000000002076

40. Taşkin, A. K., & Özçetin, B. (2023). Comparison of the efficacy of LigaSure and laser for grade 2-3 hemorrhoids. Journal of Clinical Medicine of Kazakhstan, 20(4), 33-37. https://doi.org/10.23950/jcmk/13503

41. Chen, C. W., Lu, T. J., & Hsiao, K. H. (2021). Surgical Outcomes of LigaSure Hemorrhoidectomy in the Elderly Population: A retrospective cohort study. BMC Gastroenterology, 21, 413. https://doi.org/10.1186/s12876-021-01969-1

42. Zhang, L., Xie, Y., Huang, D., Ma, X., Wang, W., Xiao, H., & Zhong, W. (2022). LigaSure hemorrhoidectomy versus the procedure for prolapse and hemorrhoids: A meta-analysis of randomized controlled trials. Medicine, 101(3), e28514. https://doi.org/10.1097/MD.0000000000028514

43. Nakhla, N., Hospattankar, A., Siddiqui, K., & Bridgeman, M. B. (2025). Improving Hemorrhoid Outcomes: A Narrative Review and Best Practices Guide for Pharmacists. Pharmacy, 13(4), 105. https://doi.org/10.3390/pharmacy13040105

44. Zilpah Sheikh, M. D. (2023). Hemorrhoids Treatment. WebMD, November 29, 2023. https://www.webmd.com/digestive-disorders/understanding-hemorrhoids-treatment-medref

45. Cusick, M. V. (2025). Expert commentary on office-based hemorrhoid treatment and complications. Diseases of the Colon & Rectum, 68(10), 1152-1153. https://doi.org/10.1097/DCR.0000000000003901

46. Thaha, M. A., Steele, R. J. C., & Jayasinghe, J. D. (2024). Hemorrhoids. BMJ Best Practice, September 27, 2024. https://bestpractice.bmj.com/topics/en-us/181

47. MacRae, H. M., & McLeod, R. S. (1997). Comparison of hemorrhoidal treatment: A meta-analysis. Diseases of the Colon & Rectum, 40(1), 14-17.

48. Patel, J., McKechnie, T., Wu, K., & et al. (2023). HEmoRhoidal disease management with Band ligation versus polidocanol Sclerotherapy: a systematic review and meta-analysis (the HerBS Review). International Journal of Colorectal Disease, 38, 112. https://doi.org/10.1007/s00384-023-04394-w

49. Gualtieri, G., Leo, P., Naldini, E., Trovato, M., De Simone, M., Lorenzon, R., Pucciarelli, F., & Pucciarelli, A. (2020). Short-Term Results of Sclerotherapy with 3% Polidocanol Foam for Symptomatic Second- and Third-Degree Hemorrhoidal Disease. Journal of Investigative Surgery, 33(8), 1059-1065. https://doi.org/10.1080/08941939.2020.1745964

50. Tan, V. Z. Z., Peck, E. W., Sivarajah, S. S., Tan, W. J., Ho, L. M. L., Ng, J. L., Chong, C., Aw, D., Mainza, F., Foo, F. J., & Koh, F. H. (2022). Systematic review and meta-analysis of postoperative pain and symptoms control following laser haemorrhoidoplasty versus Milligan-Morgan haemorrhoidectomy for symptomatic haemorrhoids: a new standard. International Journal of Colorectal Disease, 37(8), 1759-1771. https://doi.org/10.1007/s00384-022-04225-4

51. Wee, I. J. Y., Koo, C. H., Seow-En, I., Ng, Y. Y. R., Lin, W., & Tan, E. J. K. W. (2023). Laser hemorrhoidoplasty versus conventional hemorrhoidectomy for grade II/III hemorrhoids: a systematic review and meta-analysis. Annals of Coloproctology, 39(1), 3-10. https://doi.org/10.3393/ac.2022.00598.0085

52. Jiang, T., Fan, L., Tang, X., Xu, Z., & Wu, W. (2025). Superselective superior rectal artery embolization in the treatment of hemorrhoidal disease. Frontiers in Medicine, 12, 1530981. https://doi.org/10.3389/fmed.2025.1530981

53. Giannini, G., Giarratano, G., De Seta, V., Piccinini, A., Gasparini, G., & et al. (2025). Polidocanol foam sclerotherapy for hemorrhoidal disease: a systematic review and expert survey. Updates in Surgery. https://doi.org/10.1007/s13304-025-02258-2

54. Ambe, P. C., Martin-Martin, G. P., Vasas, N., Piponski, I., Roman, I. H., Hernandez, J. D. P., Ma, H., Lin, H. C., Weyand, G., Mazlan, L., García Flórez, L. J., Wolff, K., Dessily, M., Wang, C., Dobricanin, V., Yang, W., Bruketa, T., Zeng, X. D., Avdicausevic, S., Zhang, Z. G., Wais, S., Kalaskar, S., Cui, Z., Pestonit, I. B., Cao, Y. Q., Suárez Sánchez, A., Ren, D. L., Vargas Castillo, E., Zheng, D., Bogdanic, B., Wölk, A., Yao, Y., Issaad, S., Nasser, T., Guo, X. T., Nagar, M. M., Merkle, M., Ruiz-Lopez, M., Zhang, Y., Blumberg, C., Alam, A. A., Acosta, A. C., Schouten, R., Istok, P., Demtröder, C., Wang, Z. Y., Dong, Q., Wu, J., & The LHP Recommendation Development Group. (2024). Best clinical practice recommendations for the management of symptomatic hemorrhoids via laser hemorrhoidoplasty: the LHP recommendations. Techniques in Coloproctology, 29(1), 2. https://doi.org/10.1007/s10151-024-03022-1

55. Gallo, G., Dezi, A., Grossi, U., & Picciariello, A. (2023). Sclerotherapy with 3% polidocanol foam in the treatment of hemorrhoidal disease: unveiling the missing pieces for a comprehensive evaluation. Frontiers in Surgery, 10, 1344724. https://doi.org/10.3389/fsurg.2023.1344724

56. Jin, L., Qin, K., Wu, R., Yang, H., Cui, C., Wang, Z., & Wu, J. (2024). Laser hemorrhoidoplasty vs. rubber band ligation: a randomized trial comparing 2 mini-invasive treatment for grade II hemorrhoids. BMC Surgery, 24, 164. https://doi.org/10.1186/s12893-024-02425-z

57. Bashir, Y., Hussein Al-Awaysheh, M. M., Ain, Q. U., O'Connor, D., Mockler, D., & Eguare, E. (2022). Systematic Review & Meta-Analysis of Randomized Control Trials Comparing Stapled Hemorrhoidectomy versus Trans Anal Hemorrhoidal Dearterialization for Treatment of Hemorrhoidal Disease. Surgery, Gastroenterology and Oncology, 27(1), 1-12. https://doi.org/10.21614/sgo-416

58. Giordano, P., Gravante, G., Sorge, R., Ovens, P., & Nastro, P. (2008). Long-term outcomes of stapled hemorrhoidopexy vs conventional hemorrhoidectomy: a meta-analysis of randomized clinical trials. Archives of Surgery, 143(2), 226-232. https://doi.org/10.1001/archsurg.2007.40

59. Miyamoto, H. (2023). Minimally Invasive Treatment for Advanced Hemorrhoids. Journal of the Anus, Rectum and Colon, 7(1), 8-16. https://doi.org/10.23922/jarc.2022-068

60. Kang, S. I. (2025). Latest research trends on the management of hemorrhoids. Journal of the Anus, Rectum and Colon, 9(2), 179-191. https://doi.org/10.23922/jarc.2024-090

61. Wee, I. J. Y., Oo, Y., Seow, C. H., Lam, T. J., & Koh, F. H. (2024). A systematic review comparing the efficacy of 980 nm vs. 1470 nm wavelengths in laser hemorrhoidoplasty. International Journal of Colorectal Disease. https://doi.org/10.1007/s00384-024-04690-z

62. Salgueiro, P., Rei, A., Garrido, M., Rosa, B., Oliveira, A. M., Pereira-Guedes, T., Morais, S., & Castro-Poças, F. (2022). Polidocanol foam sclerotherapy in the treatment of hemorrhoidal disease in patients with bleeding disorders: a multicenter, prospective, cohort study. Techniques in Coloproctology, 26(8), 615-625. https://doi.org/10.1007/s10151-022-02600-5

63. Chen, C. W., Lu, T. J., & Hsiao, K. H. (2021). Surgical Outcomes of LigaSure Hemorrhoidectomy in the Elderly Population: A retrospective cohort study. BMC Gastroenterology, 21, 413. https://doi.org/10.1186/s12876-021-01969-1

64. Zhang, L., Xie, Y., Huang, D., Ma, X., Wang, W., Xiao, H., & Zhong, W. (2022). LigaSure hemorrhoidectomy versus the procedure for prolapse and hemorrhoids: A meta-analysis of randomized controlled trials. Medicine, 101(3), e28514. https://doi.org/10.1097/MD.0000000000028514

65. Nakhla, N., Hospattankar, A., Siddiqui, K., & Bridgeman, M. B. (2025). Improving Hemorrhoid Outcomes: A Narrative Review and Best Practices Guide for Pharmacists. Pharmacy, 13(4), 105. https://doi.org/10.3390/pharmacy13040105

66. Mayo Clinic. (2025). Hemorrhoids - Diagnosis and treatment. Mayo Clinic, August 23, 2025. https://www.mayoclinic.org/diseases-conditions/hemorrhoids/diagnosis-treatment/drc-20360280

67. Taşkin, A. K., & Özçetin, B. (2023). Comparison of the efficacy of LigaSure and laser for grade 2-3 hemorrhoids. Journal of Clinical Medicine of Kazakhstan, 20(4), 33-37. https://doi.org/10.23950/jcmk/13503

68. Patel, J., McKechnie, T., Wu, K., & et al. (2023). HEmoRhoidal disease management with Band ligation versus polidocanol Sclerotherapy: a systematic review and meta-analysis (the HerBS Review). International Journal of Colorectal Disease, 38, 112. https://doi.org/10.1007/s00384-023-04394-w

69. Jiang, T., Fan, L., Tang, X., Xu, Z., & Wu, W. (2025). Superselective superior rectal artery embolization in the treatment of hemorrhoidal disease. Frontiers in Medicine, 12, 1530981. https://doi.org/10.3389/fmed.2025.1530981