A comparative study of excisional surgery and cryohaemorrhoidectomy

Area of Science:

• Colorectal Surgery
• Minimally Invasive Procedures

Background:

• Hemorrhoids are a common condition affecting a significant portion of the population.
• Current surgical options for hemorrhoids include excisional surgery and cryohaemorrhoidectomy.
• Comparative data on the long-term outcomes and patient experience between these procedures is valuable.

Purpose of the Study:

• To prospectively compare cryohaemorrhoidectomy with traditional excisional surgery for hemorrhoid treatment.
• To evaluate key outcomes including post-operative pain, complications, hospitalization duration, and symptom recurrence.

Main Methods:

• A prospective study involving 50 patients undergoing cryohaemorrhoidectomy and 77 patients undergoing excisional surgery over 5 years.
• Data collection focused on hemorrhoid degree, pain levels, complications (bleeding, urinary retention, anal stenosis), hospitalization length, and recurrence.

Main Results:

• Cryohaemorrhoidectomy resulted in significantly less post-operative pain (14% experiencing significant pain) compared to excisional surgery (all patients).
• Hospitalization was considerably shorter after cryohaemorrhoidectomy.
• Excisional surgery was associated with higher rates of bleeding and anal stenosis.
• Cryohaemorrhoidectomy showed a higher liability to recurrence, especially in patients with prolapse.

Conclusions:

• Cryohaemorrhoidectomy is a viable option for hemorrhoid treatment, particularly beneficial for patients with bleeding as a primary symptom and minimal prolapse, offering reduced pain and shorter hospital stays.
• While cryosurgery demonstrates advantages in immediate post-operative recovery, careful patient selection is necessary due to a potential for higher recurrence rates.