An initial experience with laser hemorrhoidoplasty in patients with grade 2-3 hemorrhoids

Abstract

Hemorrhoids are detected in 11% of the adult population, and they account for 42% of all rectal disorders. According to leading coloproctology centres, about 30% of patients with chronic hemorrhoids require surgical intervention. Each of these methods has its own advantages and disadvantages. None of them, however, provides minimally invasive intervention, which is the prevailing trend in modern surgery.

Objective — to conduct a comparative analysis and evaluate the outcomes of laser hemorrhoidoplasty and Milligan‑Morgan hemorrhoidectomy for patients with grade 2—3 chronic hemorrhoids.

Materials and methods. The study presents the treatment outcomes of 59 patients with grade 2—3 chronic internal hemorrhoids. The main group included 29 patients who underwent laser hemorrhoidoplasty. As a surgical treatment, the 30 patients in the control group underwent the Milligan‑Morgan operation using an Ethicon Harmonic ultrasonic electrosurgical coagulator.

Results. Treatment of hemorrhoids with a diode laser performed by a trained surgeon in accordance with the protocol and manner of execution offers a number of advantages compared to the traditional Milligan‑Morgan procedure. These advantages include a shorter operation time (p <0.001), reduced intensity and duration of postoperative pain after laser hemorrhoidoplasty (an average of 3.59±1.15 days), whereas after Milligan‑Morgan surgery, it was 5.60±1.22 days (p <0.001), decreased incidence of postoperative bleeding, and maintaining the radicality of the removal of the cavernous tissue substrate.

Conclusions. In the surgical treatment of grade 2—3 chronic internal hemorrhoids, laser hemorrhoidoplasty of internal hemorrhoidal nodes has undeniable advantages over the standard Milligan‑Morgan procedure.