Laser Hemorrhoidoplasty: Experience at Aga Khan University Hospital

Abstract

Background: Hemorrhoidal disease is the commonest benign anal condition diagnosed in the outpatient setup. Interventional treatment options range widely, from office-based procedures to hemorrhoidectomy. Laser technology increasingly is in use in the field of proctology. We present our index clinical outcomes following laser haemorrhoidoplasty (LHP). Methodology: Retrospective cross-sectional study of 21 consecutive patients who underwent LHP between 2015 and 2018 under a single surgeon. Their outcomes were compared with a group of patients who underwent the standard open hemorrhoidectomy over the same period of time. Results: Postoperatively, 85.7% of patients post-LHP had a better pain score (mild) compared with 66.7% in the open hemorrhoidectomy group. The mean operative time in minutes was shorter for LHP, 29.67±17.50 versus 39.20±20.77 in the open group. Duration of hospital stay in days between the two groups were similar; LHP group median=1(1–3), open group median =1(1–3). Rates of infection, recurrence and urinary complications were however higher in the laser group, 4.8%, 9.5% and 9.5% respectively compared with the open hemorrhoidectomy group that were 0%, 6.7% and 6.7 % respectively. Both groups had no reported cases of stool or flatus incontinence. Conclusion: Laser haemorrhoidoplasty is associated with reduced pain scores and shorter operative time than open hemorrhoidectomy. Duration of hospital stay was similar in both groups. The rate of complications was high in the study group. Keywords: Laser haemorrhoidoplasty, Pain score, Complications, Open hemorrhoidectomy