Abstract
Hemorrhoidal disease is a common reason for consultation in proctology. It can be treated in several ways (medical, endoscopic, and surgical). Laser treatment has been described since 1960 and has developed in recent years. The purpose of this literature review was to study the results of laser treatment of hemorrhoids and to compare them with those of surgical methods. We performed a systematic search of the literature by querying the Medline, Google Scholar, and Cochrane Library databases. Retrospective studies and case reports were excluded. We selected 11 studies both techniques HeLP (hemorrhoid laser procedure) and LHP (laser hemorrhoidoplasty procedure). The total number of patients was 1179 including 1059 patients treated with laser and 120 treated surgically within the context of comparative studies. The age of the patients varies between 18 and 74 years old. HeLP laser treatment was significantly superior to surgical treatment in terms of postoperative pain (p < 0.001), hemorrhoidal disease downgrading (p < 0.001), and postoperative satisfaction (p < 0.001). Similarly, LHP laser treatment was significantly superior to surgical treatment in terms of operative duration (p < 0.00001), intraoperative bleeding (p < 0.00001), postoperative pain at H12 and H24 (p < 0.00001 and p = 0.0003), and postoperative bleeding rate (p < 0.001). The laser represents a revolution in the field of proctology mainly in the treatment of hemorrhoidal pathology. It is a safe, effective, and less painful mini-invasive technique. More rigorous studies will be needed to better evaluate this technique.
Similar content being viewed by others
References
Giamundo P, Cecchetti W, Esercizio L, Fantino G, Geraci M et al (2011) Doppler-guided hemorrhoidal laser procedure for the treatment of symptomatic hemorrhoids: a new and minimal-invasive treatment. Surg Endosc 25(5):1369–1375
Plapler H, Hage R, Duarte J, Lopes N, Masson I, Cazarini C, Fukuda T (2009) A new method for hemorrhoid surgery: intrahemorrhoidal diode laser, does it work ? Photomed Laser Surg 27(5):819–823
Jadad AR, Moore RA, Carroll D et al (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17(1):1–12
Giamundo P, Salfi R, Geraci M, Tibaldi L, Murru L, Valente M (2011) The hemorrhoid laser technique procedure vs. rubber band ligation: a randomized trial comparing 2 mini-invasive treatments for second- and third-degree hemorrhoids. Say Colon Rectu 54(6):693–8
Crea N, Pata G, Lippa M, Chiesa D, Gregorini ME, Gandolfi P (2014) Hemorrhoidal laser procedure: short-and-long-term results from a prospective study. Am J Surg 208(1):21–25
From Nardi P, Tamburini AM, Gazzetta PG, Lemma M, Pascariello A, Asteria CR (2016) Hemorrhoid laser procedure for second- and third-degree hemorrhoids: results from a multicenter prospective study. Tech Coloproctol 20(7):455–459
Giamundo P, Braini A, Calabro G, Crea N, De Nardi P, Fabiano F (2018) Doppler-guided hemorrhoidal dearterialization with laser (HeLP): a prospective analysis of data from a multicenter trial. Tech Coloproctol 22(8):635–643
Boarini P, Boarini LR, Boarini MR, de Lima EM, Candelaria P (2017) Hemorrhoidal laser procedure (HeLP): a painless treatment for hemorrhoids. J Inflam Bowel Dis Disor 2(2):118
Jahanshahi A, Mashhadizadeh E, Sarmast MH (2012) Diode laser for treatment of symptomatic hemorrhoid: a short term clinical result of a mini invasive treatment, and one year follow up. Pol Przegl Chir 84(7):329–332
Karahaliloglu AF (2007) First results after laser obliteration of first- and second-degree hemorrhoids. Coloproctology 29(6):327–35
Maloku H, Gashi Z, Lazovic R, Islami H, Juniku-Shkololli A (2014) Laser hemorrhoidoplasty procedure vs. open surgical hemorrhoidectomy: a comparative trial 2 treatments for hemorrhoids of third and fourth degree. Acta Inform Med 22(6):36–57
Naderan M, Shoar S, Nazari M, Elsayed A, Mahmoodzadeh H (2017) Randomized controlled trial comparative intra-hemorrhoidal laser coagulation and Milligan-Morgan hemorrhoidectomy. J Invest Surg 30(5):325–331
SadraNazari M, KeshavarzHedayati M (2015) Comparison of intrahemorrhoidal coagulation with 980 nanometer laser diode and Milligan Morgan hemorrhoidectomy: a randomized clinical trial. J Clin Res Gov 4(2):1–4
Brusciano L, Gambardella C, Terracciano G, Gualtieri G, di Visconte MS (2020) Postoperative discomfort and pain in the management of hemorrhoidal disease: laser hemorrhoidoplasty, a minimal invasive treatment of symptomatic hemorrhoids. Updates Surg 72(3):851–857
Claudio Gambardella, Luigi Brusciano, Gianmattia Del Genio, Salvatore Tolone, Gianmattia Terracciano. Predictive parameters to identify incontinent patients amenable for rehabilitation treatment: the muscular synergies evaluation. Arq. Gastroenterol. 2019.
Brusciano L, Gambardella C, Tolone S, del Genio G, Terracciano G (2019) An imaginary cuboid: chest, abdomen, vertebral column and perineum, diferent parts of the same whole in the harmonic functioning of the pelvic foor. Tech Coloproctol 23(2):101–115
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare no competing interests.
Additional information
Publisher's note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Trigui, A., Rejab, H., Akrout, A. et al. Laser utility in the treatment of hemorrhoidal pathology: a review of literature. Lasers Med Sci 37, 693–699 (2022). https://doi.org/10.1007/s10103-021-03333-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10103-021-03333-x