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Clinical Outcomes and Effectiveness of Laser Treatment for Hemorrhoids: A Systematic Review

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Abstract

Background

Laser treatment is increasingly used in the treatment of symptomatic hemorrhoids, and several studies have attempted to describe its clinical outcomes. In this systematic review, we aimed to comprehensively analyze the clinical outcomes and effectiveness of laser treatment.

Methods

We performed a systematic review of currently available data on laser treatment for hemorrhoids. We searched MEDLINE and Google Scholar between January 2009 and May 2020. Studies that described the clinical outcomes and effectiveness of laser treatment were selected based on pre-specified inclusion criteria with a minimum follow-up period of 3 months. Qualitative synthesis of the clinical outcomes, effectiveness and complications was performed.

Results

Nineteen studies including 1937 patients were analyzed. The majority were males (n = 1239) and included grade 2 and 3 hemorrhoids. In the majority (n = 1750, 90.34%), the 980 nm wave length diode laser was used as the energy source. Doppler-guided localization was performed in six studies (n = 579, 29.89%). All studies (n = 1937) reported low postoperative pain scores and nine studies (n = 1131) showed significantly lower pain compared to open technique. Furthermore, six studies (n = 1023) showed significantly less intra- and postoperative bleeding compared to open technique. Seven studies (n = 1052) reported long-term follow-up results and were found to be satisfactory in terms of symptom relief and recurrence. This study was limited by heterogeneity of outcomes precluding a meta-analysis.

Conclusion

Laser treatment had acceptable clinical outcomes for grade 2 and 3 hemorrhoids with lower rates of postoperative pain and bleeding with satisfactory long-term outcomes.

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Data availability

The datasets generated and analyzed during the current study are included in the manuscript.

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Funding

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Authors and Affiliations

  1. Department of Surgery, Faculty of Medicine, University of Colombo, P.O. Box 271, Kynsey Road, Colombo 8, Western Province, Sri Lanka

    Kasun Lakmal, Oshan Basnayake, Umesh Jayarajah & Dharmabandhu N. Samarasekera

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  1. Kasun Lakmal
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  3. Umesh Jayarajah
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  4. Dharmabandhu N. Samarasekera
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Contributions

KL, OB and UJ designed the tables; collected, analyzed, and interpreted data; and wrote the article. KL, OB and UJ formulated the concept and design of study, acquisition of data and analysis and drafting the article. DNS contributed to design and concept of study, revising it critically for important intellectual content and approval of the final version to be published. All authors have read and approved the final version of the manuscript.

Corresponding author

Correspondence to Dharmabandhu N. Samarasekera.

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K. Lakmal and O. Basnayake have contributed equally to this work.

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Lakmal, K., Basnayake, O., Jayarajah, U. et al. Clinical Outcomes and Effectiveness of Laser Treatment for Hemorrhoids: A Systematic Review. World J Surg 45, 1222–1236 (2021). https://doi.org/10.1007/s00268-020-05923-2

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