CLINICAL SHORT-TERM OUTCOMES OF LASER HEMORRHOIDOPLASTY: A MULTICENTER STUDY
Received 2021-07-29; Accepted 2022-01-07; Published 2022-07-01
Background: Laser hemorrhoidoplasty (LHP) is a treatment for symptomatic internal hemorrhoids. Nevertheless, there are disparities in the technique employed, including combining it with pedicle ligation. We aimed to investigate if short-term clinical outcomes were different between patients undergoing LHP with and without pedicle.
Methods: Patients who underwent LHP from a prospective registry of 3 centers were identified. Demographics, severity, symptoms, operative technique, post-operative pain, complications, and recurrence were investigated. Sub-investigation of patients with simultaneous pedicle ligation, and without, was performed. Statistical analysis was done using the χ2 test. P values <0.05 were noted as statistically significant.
Results: One hundred and two patients (59.8% male) of a mean age of 45 years were assessed. Most (62.7%) had 3rd degree hemorrhoids. Median operative time was 24 minutes (10-60 minutes) minutes. Post-operative length of stay was 26 hours (2-168 hours) hours. Median pain score 24 hours post-operatively was 0/10. The general complication percentage was 26.5%, but majority complications were self-limiting. The most common complication was post-operative swelling (16 patients; 15.7%). Post-operative bleeding was seen in 9 patients (8.8%) at a median of 7 (1-14) days, 3 of whom needed operation and readmission. Then 4 patients (3.9%) had moderate-to-severe pain (pain score of more than 5/10), 2 patients (2.0%) developed ulceration and 3 patients (2.9%) had recurrence, were treated conservatively. Patients with pedicle ligation had a higher complication (33.3% vs. 14.8%; p=0.08), mainly bleeding and swelling but not statistically significant.
Conclusions: LHP demonstrates good short-term outcomes with minimal complication and recurrence incidences. Supplementary ligation of pedicles does not provide additional benefits, and in fact, may worsen outcomes.
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