ABSTRACT
Aims:Stapler hemorrhoidopexy (SH) has evolved over time as a procedure of choice over conventional surgery due to less postoperative pain. Laser hemorrhoidoplasty (LH) is a novel procedure aimed at shrinking the terminal branches of hemorrhoidal arteries with fewer complications. The present study is aimed to compare these procedures (SH and LH).Study Design:Prospective comparative study.Place and Duration of Study:Patients operated for hemorrhoids at the Department of General, MI & Bariatric Surgery, Artemis Hospitals, Gurgaon from April 2018 to March 2019. Methodology:50 patients with grade II-III hemorrhoids were allocated to two groups: Stapler hemorrhoidopexy(SH) and Laser hemorrhoidoplasty (LH) with 25 patients in each group. Results were compared and patients were followed up for minimum period of 3months Results:The mean operative time was 24.6 min (LH) and 28.6 min (SH) (P=.122). The average blood loss was 8.32 ml (LH) and 11.64 ml (SH) (P <.05). The mean hospital stay 21.44 hours (LH) and 32.64 hours (SH) (P <.05). Mean postoperative pain score (VAS) at 12 hours was 2.64 (LH) and 4.76 (SH) (P <.05), at 24 hours was 1.88 (LH) and 3.6 (SH) (P <.05), at 1 week was 0.36 (LH) and 0.88 (SH) (P =.054) and at 3 months 0.04 (LH) and 0.12 (SH) (P =.53). One patient in LH (4%) had postoperative bleeding on 4th postoperative day. In SH group, 2 (8%) had severe postoperative pain with VAS > 8, requiring longer hospital stay, 2 (8%) had bleeding on the same day, 1(4%) had bleeding on follow up and 1 (4%) had recurrence. Conclusion:In terms of early postoperative pain and complications, LH offers better results as compared to SH. It was associated with a shorter hospital stay and earlyreturn to work. No significant complications were noted in LH compared to SH. LH is an extremely viable alternative to the popular SH for grade II-III hemorrhoids.