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Short‐ and long‐term outcomes of laser haemorrhoidoplasty for grade II – III haemorrhoidal disease
Author(s) -
Faes S.,
Pratsinis M.,
HaslerGehrer S.,
Keerl A.,
Nocito A.
Publication year - 2019
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.14572
Subject(s) - medicine , surgery , stage (stratigraphy) , visual analogue scale , patient satisfaction , paleontology , biology
Aim Laser haemorrhoidoplasty is associated with minimal postoperative pain and good symptom improvement in the short‐term. However, less is known about its long‐term efficacy. This study aims to determine the short‐ and long‐term outcomes of laser haemorrhoidoplasty. Method Between October 2010 and May 2012, 50 consecutive patients with grade II – III haemorrhoids were treated with laser haemorrhoidoplasty. Short‐term follow‐up was assessed on days 1, 30 and 60 and long‐term follow‐up was at 5 years (haemorrhoidal stage reduction, pain, patient satisfaction, symptom improvement, incapacity for work, continence, complications, recurrence). Results Short‐term follow‐up was achieved for all patients and long‐term follow‐up for 44/50 patients (88%). At short‐term follow‐up, haemorrhoidal stage reduction was documented in 49 (98%) patients. Complete or good symptom improvement was reported by 36/50 (72%) and 10/50 patients (20%) at 60 days. Postoperative complications occurred in 9/50 patients (18%) with three Clavien–Dindo grade III b complications (two fistulas, one incontinence), one grade III a (perianal thrombosis) and five grade I (one perianal thrombosis, two perianal eczema, one local bleeding, one anal fissure). Postoperative pain was low (visual analogue scale 0–1) at day 1 in 37/50 (74%), at day 30 in 47/50 (94%) and at day 60 in 50/50 patients (100%). After a mean follow‐up of 5.4 years ( SD 5.4 months) the recurrence rate was 34% (15/44 patients) with a median time to recurrence of 21 months (range 0.2–6 years). Conclusion Although laser haemorrhoidoplasty achieves a high short‐term success rate with respect to stage reduction and symptom improvement, it is associated with a high rate of minor postoperative complications and long‐term recurrence. Therefore, laser haemorrhoidoplasty should be used with caution.