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LASER Haemorrhoidoplasty versus Stapler Haemorrhoidopexy: A Prospective Comparative Study
K R Majumder1, T A Alam, M Rassell
1Dr Krisna Rani Majumder, Associate Professor of Surgical Oncology, Department of Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh;
Abstract:
LASER Haemorrhoidoplasty (LH) is a novel procedure in modern medical science. It is a no cut, painless and bloodless clinical procedure with comparatively fewer complications in comparison to Stapler Haemorrhoidopexy (SH) for the treatment of grade III-IV haemorrhoids. It is very applicable surgical procedure at shrinking the terminal branches of haemorrhiodal arteries with fewer complications than Stapler Haemorrhoidopexy (SH). The aim of the study was to compare LASER Haemorrhoidoplasty (LH) with Stapler Haemorrhoidopexy (SH). The comparative study was performed in Bangabandhu Sheikh Mujib Medical University (BSMMU), Anower Khan Modern Medical College and Hospital and Care Medical College and Hospital, Dhaka, Bangladesh from August 2019 to July 2020. A total of 84 patients with grade III-IV haemorrhoids were allocated into two groups: LASER Haemorrhoidoplasty (LH) and Stapler Haemorrhoidopexy (SH) with 42 patients in each group prospectively. Comparative results and post-operative follow up periods were 4 months. The mean operative time was 28.6min (LH) and 36.2min (SH) (p=0.0006). The average blood loss was 6.42ml (LH) and 12.6ml (SH) (p<0.05). The mean hospital stay 18.36 hours (LH) and 28.40 hours (SH) (p<0.05). Mean postoperative pain score (VAS) at 12 hours was 3.8 (LH) and 6.81 (SH) (p<0.05), at 24 hours was 2.6 (LH) and 4.6 (SH) (p<0.05), at 1 week was 0.46 (LH) and 0.88 (SH) (p=0.05) and at 3 months 0.04 (LH) and 0.10 (SH) (p=0.401). Complications were found in (2.4%) patients ≤1 week in the (LH) group 7(16.7%) in the (SH) group which was statistically significant (p<0.05) between the two groups. Patients with haemorrhoids treated with LASER Haemorrhoidoplasty had a better outcome than stapler haemorrhoidopexy in terms of early postoperative pain as well as complications and was associated with a shorter hospital stay and early return to work. LASER Haemorrhoidoplasty was most effective and alternative to the popular stapler Haemorrhoidopexy for grade III-IV haemorrhoids.
