Nicola Crea1, Giacomo Pata2, Mauro Lippa3, Deborah Chiesa4, Maria Elena Gregorini5, Paolo Gandolfi3. 1. Department of General Surgery, San Camillo Clinic Institute, Via Turati 44, 25123 Brescia, Italy. Electronic address: cirioz@libero.it. 2. Department of Medical and Surgical Sciences, Second Division of General Surgery, Brescia Civic Hospital, Brescia, Italy. 3. Department of General Surgery, San Camillo Clinic Institute, Via Turati 44, 25123 Brescia, Italy. 4. Department of Medical and Surgical Sciences, Third Division of Internal Medicine, University of Brescia School of Medicine, Brescia Civic Hospital, Brescia, Italy. 5. Maternal-Fetal Medicine Unit, Department of Obstetrics and Gynaecology, University of Brescia School of Medicine, Brescia Civic Hospital, Brescia, Italy.
Abstract
BACKGROUND: We report the results of 2-year regular use of the hemorrhoidal laser procedure (HeLP) in 97 patients with symptomatic second- to third-grade hemorrhoids with minimal or moderate internal mucosal prolapse. METHODS: Data on duration of the procedure, perioperative complications, postoperative pain, downgrading of hemorrhoids, resolution or persistency, and recurrence of hemorrhoidal disease (HD) were prospectively collected. RESULTS: No significant intraoperative complications occurred. The median follow-up was 15 months. Postoperative pain was null in most patients. There were no cases of rectal tenesmus or alteration of defecation habits. Symptoms and HD downgrading reached a "plateau" at 3 to 6 months after the HeLP. At this evaluation, frequency of bleeding, pain, itching, and hemorrhoidal acute syndrome decreased by 76% to 79%. HD grade showed a significant reduction. HD recurrence rate was 5% at 2 years. CONCLUSIONS: Our study demonstrates that the HeLP is a safe, effective, and painless technique for the treatment of symptomatic second- to third-grade hemorrhoids with minimal or moderate mucosal prolapse, ideally suitable as ambulatory treatment.
BACKGROUND: We report the results of 2-year regular use of the hemorrhoidal laser procedure (HeLP) in 97 patients with symptomatic second- to third-grade hemorrhoids with minimal or moderate internal mucosal prolapse. METHODS: Data on duration of the procedure, perioperative complications, postoperative pain, downgrading of hemorrhoids, resolution or persistency, and recurrence of hemorrhoidal disease (HD) were prospectively collected. RESULTS: No significant intraoperative complications occurred. The median follow-up was 15 months. Postoperative pain was null in most patients. There were no cases of rectal tenesmus or alteration of defecation habits. Symptoms and HD downgrading reached a "plateau" at 3 to 6 months after the HeLP. At this evaluation, frequency of bleeding, pain, itching, and hemorrhoidal acute syndrome decreased by 76% to 79%. HD grade showed a significant reduction. HD recurrence rate was 5% at 2 years. CONCLUSIONS: Our study demonstrates that the HeLP is a safe, effective, and painless technique for the treatment of symptomatic second- to third-grade hemorrhoids with minimal or moderate mucosal prolapse, ideally suitable as ambulatory treatment.
Authors: P Giamundo; A Braini; G Calabro'; N Crea; P De Nardi; F Fabiano; M Lippa; A Mastromarino; A M Tamburini Journal: Tech Coloproctol Date: 2018-08-29 Impact factor: 3.781