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Postoperative discomfort and pain in the management of hemorrhoidal disease: laser hemorrhoidoplasty, a minimal invasive treatment of symptomatic hemorrhoids

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Abstract

Hemorrhoidal disease (HD) treatment still remains controversial. In fact, despite many surgical progresses, postoperative pain, and discomfort remain the major weaknesses. Laser hemorrhoidoplasty (LHP) is a minimal invasive procedure for HD treatment determining the shrinkage of the hemorrhoidal piles by diode laser. The aim of the current study is to analyze the feasibility and efficacy of LHP in patients with II–III degrees hemorrhoids. Consecutive patients with II–III degree hemorrhoids were enrolled in the study and underwent an LHP treatment using a 1470-nm diode laser. Operative time, postoperative pain and complications, resolution of symptoms, and length of return to daily activity were prospectively evaluated. Recurrence of prolapsed hemorrhoid or symptoms at a minimum follow-up of 6 months was evaluated. Fifty patients (28 males and 22 females) were enrolled in the study. No significant intraoperative complications occurred. Postoperative pain score (at 12, 18, and 24 h postoperatively), evaluated through visual analogue scale, was extremely low (mean value 2). No postoperative spontaneous bleeding occurred. The 100% of our population came back to daily activity 2 days after surgery. At a mean follow-up period of 8.6 months, we reported a recurrence rate of 0%. LHP demonstrated a large efficacy in selected patients. The greatest strength points were low postoperative pain, the presence of slightly significant peri-anal wounds, no special anal hygienic measures and low surgical time. Thus, resulting in a negligible postoperative discomfort, LHP could be considered a painless and minimal invasive technique in the treatment of HD.

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Availability of data and materials

The data sets used and/or analyzed during the current study are available from the XI Division of General, Mini-invasive and Obesity Surgery—Master of Coloproctology and Master of Pelvi-Perineal Rehabilitation. University of Study of Campania “Luigi Vanvitelli” Naples, on reasonable request.

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Author notes

  1. Luigi Brusciano and Claudio Gambardella contributed equally to the paper.

Authors and Affiliations

  1. University of Study of Campania “Luigi Vanvitelli”, via Luigi Pansini n° 5, 80131, Naples, Italy

    Luigi Brusciano, Claudio Gambardella, Gianmattia Terracciano, Giorgia Gualtieri, Salvatore Tolone, Gianmattia del Genio & Ludovico Docimo

  2. Department of Cardiothoracic Sciences, School of Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy

    Claudio Gambardella

  3. “S. Maria dei Battuti” Hospital, Conegliano, Conegliano, TV, Italy

    Michele Schiano di Visconte

Authors
  1. Luigi Brusciano
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  2. Claudio Gambardella
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  3. Gianmattia Terracciano
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  4. Giorgia Gualtieri
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  5. Michele Schiano di Visconte
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  6. Salvatore Tolone
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  7. Gianmattia del Genio
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  8. Ludovico Docimo
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Contributions

All authors contributed significantly to the present research and reviewed the entire manuscript. LB participated substantially in conception, design and execution of the study and in the analysis and interpretation of the data; also participated substantially in the drafting and editing of the manuscript. CG participated substantially in conception, design, and execution of the study and in the analysis and interpretation of the data; also participated substantially in the drafting and editing of the manuscript. GT participated substantially in conception, design and execution of the study and in the analysis and interpretation of the data. GG participated substantially in conception, design and execution of the study and in the analysis and interpretation of the data. MSdV participated substantially in conception, design and execution of the study and in the analysis and interpretation of the data. ST participated substantially in conception, design and execution of the study and in the analysis and interpretation of the data. GdG participated substantially in conception, design and execution of the study and in the analysis and interpretation of the data. LD participated substantially in conception, design and execution of the study and in the analysis and interpretation of the data.

Corresponding author

Correspondence to Ludovico Docimo.

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The authors declare that they have no competing interests.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (University of Campania “Luigi Vanvitelli” Ethical Comitee-370/18) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Brusciano, L., Gambardella, C., Terracciano, G. et al. Postoperative discomfort and pain in the management of hemorrhoidal disease: laser hemorrhoidoplasty, a minimal invasive treatment of symptomatic hemorrhoids. Updates Surg 72, 851–857 (2020). https://doi.org/10.1007/s13304-019-00694-5

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  • DOI: https://doi.org/10.1007/s13304-019-00694-5

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