[Submucosal laser ablation of internal hemorrhoids]

Area of Science:

• Gastroenterology
• Minimally Invasive Surgery
• Laser Therapeutics

Background:

• Internal hemorrhoids affect a significant portion of the population.
• Current treatment options for internal hemorrhoids vary in efficacy and invasiveness.
• Submucosal laser ablation (SLT) presents a minimally invasive approach.

Purpose of the Study:

• To systematically review the efficacy and safety of submucosal laser ablation (SLT) for internal hemorrhoid treatment.
• To analyze outcomes based on available prospective clinical trial data.

Main Methods:

• Systematic review of 10 prospective clinical trials from PubMed, Cochrane Library, and Elibrary up to January 2019.
• Included studies focused on isolated SLT or SLT combined with other minimally invasive procedures.
• Data extraction on efficacy, safety, and complications associated with SLT.

Main Results:

• SLT is primarily used for hemorrhoids grades 2-3.
• Procedure efficacy ranged from 91.1-100% at 6 months and 87.5-100% at 12 months.
• Reported complications included bleeding (8.4%), edema (8.2%), urinary retention (1.2%), anal fistula (0.6%), and perianal abscess (0.14%).

Conclusions:

• Submucosal laser ablation is an effective and safe treatment for grades 2-3 internal hemorrhoids.
• Further research is necessary to establish clear guidelines for laser parameters and indications.
• Long-term outcome data is limited, warranting additional investigation.