CLINICAL SHORT-TERM OUTCOMES OF LASER HEMORRHOIDOPLASTY: A MULTICENTER STUDY
https://doi.org/10.22452/jummec.vol25no2.12
- Author:
Hoong Yin Chong
1
;
April C Roslani
1
;
Retnagowri Rajandram
1
;
Sandip Kumar
1
;
Ausama A Malik
1
;
Chee Wei Law
1
;
Siew How Chan
2
;
Vijeyasingam Rajasingam
3
;
Jeyaratnam Kasipillai
3
Author Information
1. Department of Surgery, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
2. Pantai Hospital Ampang, 55100 Kuala Lumpur, Malaysia
3. Assunta Hospital, 46990 Petaling Jaya, Selangor, Malaysia
- Publication Type:Journal Article
- Keywords:
Hemorrhoids;
Ligation;
Outcomes;
Pedicle;
Short-term
- MeSH:
Hemorrhoids
- From:Journal of University of Malaya Medical Centre
2022;25(2):73-78
- CountryMalaysia
- Language:English
-
Abstract:
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.
- Full text:202508151119514559198833.pdf
