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ORIGINAL ARTICLE
Year : 2019  |  Volume : 32  |  Issue : 2  |  Page : 560-565

Comparative study between intrahemorrhoidal diode laser treatment and Milligan–Morgan hemorrhoidectomy


1 Department of General Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of General Surgery, Ministry of Health, Mansoura, Dakahlia Governorate, Egypt

Correspondence Address:
Ibrahim EI Salem
Temy El-Amded, Dakahlia Governorate
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mmj.mmj_101_18

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Objective The aim of this study was to compare between intrahemorrhoidal diode laser coagulation with Milligan–Morgan (MM) hemorrhoidectomy. Background Because of the increased number of patients suffering from hemorrhoids and increased complications of MM hemorrhoidectomy, using intrahemorrhoidal diode laser therapy in this study was proved to be beneficial in terms of being easily used, noninvasive, nontoxic, painless, and highly effective. Patients and methods This study included 60 patients with symptomatic hemorrhoids of grades II and III. Thirty patients were treated with intrahemorrhoidal diode laser coagulation and the remaining were treated with MM hemorrhoidectomy. We measured operative time, postoperative pain, complications, and resolution of symptoms. We followed up patients for 3 months for evaluating healing, resolution of symptoms, and complications. Results Postoperative pain scores at the first 24 h were significantly lower in the laser group compared with the MM group (P < 0.001). The operative time and intraoperative bleeding were much more in the MM group (P < 0.001). The consumption of analgesics was significantly reduced in the laser group (P = 0.018). Three patients in the laser group were presented with thrombosis of hemorrhoids 3–4 days after the laser procedure, which was resolved with medical treatment, but no patients in the MM group developed thrombosis of hemorrhoids (P = 0.076). Three months of follow-up showed comparable results in terms of resolution of symptoms and curability rate. Conclusion Intrahemorrhoidal therapy with a 980-nm diode laser is associated with reduction of postoperative pain, intraoperative bleeding, and administered with analgesics. Our results suggest that intrahemorrhoidal diode laser treatment if available is preferred to open hemorrhoidectomy.


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