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Research Article

JCDR. 2021; 12(5): 2126-2131


Laser Hemorrhoidoplasty Procedure versus Conventional Open Surgical Hemorrhoidectomy

Wesam Nuri Yahya, Doaa Omar Refaat, Waleed Ahmed AbdElhady, Walid Abdelmawla Elsayed.


Abstract

Background: Hemorrhoids affect millions of people around the world, and represent a major medical
and socioeconomic problem. There are many treatments of hemorrhoids varying from medications and
band ligation to stapled hemorrhoidopexy, laser photocoagulation, sclerotherapy, Doppler-guided
artery ligation, and finally surgery. The current study aimed to compare between laser
hemorrhoidoplasty and conventional open surgical hemorrhoidectomy in treatment of the
hemorrhoidal diseases. Patients and methods: This comparative study conducted on 30 patients with
symptomatic hemorrhoidal diseases; divided equally into open method (MMH) group and laser
method (LHP) group. Postoperative infection was evaluated at 1, 2, 4, 6 weeks and after 6 months.
Fecal incontinence were assessed using wexner score. Results: Only one case found with mild
infection in LHP group in 1st week and 2 cases found with Mild infection in MMH group in 1st week
and one case in 2nd week managed byciprofloxacin 500 tab two times per day for one week the no
significant difference was found between groups regarding infection. After 6 months of post-operative
follow up we found one case in the open group with a total score of 2(mild incontinence) after
postoperative fecal incontinence assessment by Wexner score, with no significant difference.
Postoperative urine retention occurred in one case in the MMH group and managed with foley
catheter, with no significant difference. The mean time for wound healing/days 21.63±2.36 in MMH
group and 5.36±1.85 in LHP group and the mean time to return to normal activity / days in MMH was
24.85±3.58 days and in LHP was 7.41±2.11 days. No patients developed anal stenosis or recurrence in
both groups. Conclusion: Laser hemorrhoidoplasty technique is a modality of minimally invasive
technique for treatment of patients with hemorrhoids, which considered better method for hemorrhoids
management with less complications (pain, infection, urine retention and fecal incontinence) than open
surgical hemorrhoidectomy.

Key words: Surgical hemorrhoidectomy; Wexner score; Laser hemorrhoidoplasty, fecal incontinence






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