Title: Laser Hemorrhoidoplasty and Lateral sphincterotomy Procedures vs Conservative Treatment for Hemorrhoids and Fissure in Ano: A Trial Comparing Laser and Conservative treatments
Authors: Dr Anand Pandiyaraj , Dr Muthuraman, Dr Dinesh Kumar, Dr Muthu Bala, Dr Sharannya
DOI: https://dx.doi.org/10.18535/jmscr/v12i08.11
Abstract
Objective: According to the ‘‘vascular’’ theory, arterial overflow in the superior hemorrhoidal arteries would lead to dilatation of the hemorrhoidal venous plexus. Hemorrhoid laser procedure (LHP) is a new laser procedure for outpatient treatment of hemorrhoids in which hemorrhoidal arterial flow feeding the hemorrhoidal plexus is stopped by laser coagulation.
Aim: Our aim was to compare the hemorrhoid laser procedure and laser aided lateral sphincterotomy vs conservative treatment of symptomatic hemorrhoids and fissure in ano.
Material and Method: A comparison trial between hemorrhoid laser procedure, lateral sphincterotomy and conservative treatment for hemorrhoids and fissure in ano was made. This study was conducted at Vels Medical College and Hospital, Manjankaranai, Tamil Nadu. Patients with symptomatic grade III or grade IV hemorrhoids with minimal or complete mucosal prolapse were eligible for the study: 30 patients treated with the laser hemorrhoidoplasty, 30 patients–with laser aided lateral sphincterotomy and 40 patients treated with conservative methods. Operative time, postoperative pain, post-op healing time were evaluated.
Results: A total number of 100 patients ( 65 men and 35 women, mean age, 46 years) entered the trial. Significant differences between laser hemorrhoidoplasty, laser sphincterotomy and conservative treatments were observed in operative time and early postoperative pain. The procedure time for LHP was 15.49 min laser aided lateral sphincterotomy was 10.19 min.
Conclusion: The laser hemorrhoidoplasty and laser guided sphincterotomy procedures were more effective than conservative methods. Postoperative pain and healing time were drastically less in the early and late post op period.
References
- Johanson JF, Sonnenberg A. The prevalence of hemorrhoids and chronic constipation: an epidemiological Gastroenterology. 1990;98(2):380–386. [PubMed] [Google Scholar]
- Salfi R. A new technique for ambulantory hemorrhoidal treatment Doppler-guided laser photocoagulation of hemorrhoidal arteries. 2009;31:99–103.
- Laurie Barcly. Best option for evaluating and treating hemorrhoids. 2008 Feb 25;336:380–383. [Google Scholar]
- Milligan ET, Morgan CN, Jones LE, Officer R. Surgical anatomy of the anal canal and the operative treatment of hemorrhoids. 1937;2:1119–1124. [Google Scholar]