Mechanism-oriented three-level classification of treatment methods for chronic hemorrhoidal disease. Review
DOI:
https://doi.org/10.30978/GS-2026-1-64Keywords:
hemorrhoidal disease, hemorrhoids, mechanism‑based classification, treatment strategies, minimally invasive procedures, hemorrhoidectomyAbstract
Objective – to synthesize current approaches to the treatment of chronic hemorrhoids and to develop a mechanism-oriented classification of treatment methods that integrates the pathophysiological mechanism of action of interventions, the anatomical target of treatment, the degree of surgical invasiveness, and the organ-preserving potential of the procedures.
A comprehensive analysis of current literature on the pathogenesis of hemorrhoidal disease and its treatment modalities was conducted. The principal pathophysiological mechanisms underlying the disease, major therapeutic strategies for their correction, and corresponding clinical intervention technologies were systematized. Based on a conceptual analysis, a model of the interrelationships between pathogenic mechanisms, therapeutic strategies, and clinical treatment methods was constructed, forming the foundation for the proposed classification system. A mechanism-oriented classification of treatment methods for hemorrhoidal disease was developed, integrating pathophysiological mechanisms, therapeutic strategies for their correction, and clinical intervention technologies within a unified conceptual framework. The main therapeutic strategies identified include symptom control, induction of fibrosis of hemorrhoidal cushions, reduction of arterial inflow, intratissue remodeling, reconstruction of anal canal anatomy, and radical excision of pathologically altered tissues. Within each strategy, corresponding clinical treatment methods were systematized, allowing diverse modern technologies to be interpreted as specific implementations of a limited number of fundamental therapeutic mechanisms.
Conclusions. The proposed classification enables systematic organization of contemporary treatment methods for hemorrhoidal disease according to their underlying pathophysiological mechanisms and integrates them within a unified conceptual model. This approach provides a methodological basis for a more consistent interpretation of modern treatment technologies and may be applied in future comparative clinical studies.
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