“Comparative study between laser hemorroidoplasty and conventional hemorrhoidectomy”

Background and aim Laser Hemorrhoidoplasty (LHP) is a minimally invasive, painless laser procedure for treating hemorrhoids. Although LHP is claimed to have questionable benefits compared with conventional methods, it is still not gaining popularity as a routine practice in many countries like Egypt with no research done over the Egyptian population. The study aimed to compare LHP versus Milligan–Morgan hemorrhoidectomy in patients with grade III and grade IV hemorrhoids. Patients and methods A randomized clinical trial was conducted on 100 patients with grade III, IV hemorrhoids after failure of medical treatment. Patients were divided into two equal groups: group Ӏ: patients underwent Milligan–Morgan hemorrhoidectomy and group II: patients underwent LHP. Results The mean operative time was significantly longer in the Milligan–Morgan hemorrhoidectomy group. The mean number of days spent by the patient to return to usual daily activities was significantly shorter in the LHP group. The pain score was significantly lower in the laser group than Milligan–Morgan group on the first day of surgery, first week thereafter and 3 months ( P <0.0001). The frequency of bleeding on the first day of surgery was significantly higher in the group of patients who underwent Milligan–Morgan hemorrhoidectomy ( P =0.02). The postoperative discharge was significantly higher in the Milligan–Morgan hemorrhoidectomy group ( P =0.001). Conclusions LHP is minimally invasive technique which is the coagulation of hemorrhoidal plexus. Given the great significance of reducing postoperative pain, bleeding, mucous discharge, compared with conventional Milligan–Morgan surgery.