Transmucosal laser ablation for combined hemorrhoids of 2–3 stages

AIM: to assess of the results of transmucosal laser ablation (TMLA) for internal piles and simultaneous elimination of external piles in patients with combined hemorrhoids of 2–3 stages.

PATIENTS AND METHODS: the retrospective study included 226 patients. TMLA of internal nodes with excision or destruction of external piles was performed in 136 patients (the main group) and 90 laser destructions of internal nodes only consisted the control group. The procedure was performed under local anesthesia on a Lakhta-Milon device with a wavelength of 1.47 μm with a power of 8.0 W. The operation time, the pain syndrome, its duration after surgery, the complication rate and the recurrence rate up to 18 months were estimated.

RESULTS: the operation time in the main group was 15.0 minutes (10 min in control group; p = 0.001), the pain intensity during procedure was determined by patients at 2.5 points of VAS (2.5 — in controls; p = 0.81). Postoperative pain was detected up to 6 days (5 days in controls; p = 0.44). Postoperative bleeding occurred in 4 (2.9%) (8 — in controls; p = 0.051), recurrence occurred in 3 (4.8%) patients after 12 months (1 patient in controls; p = 0.5).

СONCLUSION: TMLA has a good tolerability and good late results, which is the motivation for wide implementation for patients with hemorrhoids in outpatient basis.

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