A comparative study between stapled hemorrhoidopexy and laser hemorrhoidoplasty in the treatment of second-degree and third-degree hemorrhoids

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Abstract

Background
Hemorrhoidal disease is the most common disease of the anorectal region. Its symptoms are variable, including bleeding, pain, discharge, and itching, which may be troublesome. Treatment options include conservative medical, conventional surgical, minimally invasive, stapled hemorrhoidopexy (SH), and recently, laser hemorrhoidoplasty (LH).
Aim
The aim of this study is to compare SH and LH in the management of second-degree and third-degree piles in terms of postoperative pain, bleeding, incontinence, stenosis, recurrence, and patient satisfaction.
Patients and methods
Thirty patients who underwent SH were prospectively compared to 30 patients who underwent LH between January 2019 and January 2020 and a 1-year follow-up at Ain Shams University Hospitals was performed. Efficacy and tolerability in terms of postoperative pain, bleeding, incontinence, stenosis, and recurrence were compared.
Results
Lower postoperative pain scores with the need for fewer analgesics were noted after LH, with shorter hospital stay, early return to daily activities, and lower incidence of incontinence, while lower postoperative bleeding incidences and recurrence rates were noted following SH. No incidence of postoperative anal stenosis was found with both the procedures, and the overall satisfaction was almost equal.
Conclusion
LH is a simple and safe technique with less postoperative pain, operative time, and hospital stay, but with a higher rate of recurrence, while SH is a more reliable technique with less postoperative bleeding and recurrence, and may be a suitable alternative to conventional hemorrhoidectomy.

Keywords

The Egyptian Journal of Surgery
Volume 40, Issue 4
October 2021
Pages 1046-1055

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