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Session: ePoster: Benign Anorectal 2 (Sun1230)

EP408 - A Comparative Study of Postoperative Pain and Complications Between Traditional Hemorrhoidectomy and Laser Hemorrhoidoplasty with External Hemorrhoidectomy

Sunday, May 11, 2025
12:35 PM - 12:40 PM PT
Location: Monitor 2, Sails Pavilion, Upper Level

    Author(s)

  • Tai-Chuan Kuan, surgery

    attending surgeon
    Far Eastern Memorial Hospital
    NEw Taipei City, New Taipei, Taiwan (Republic of China)

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • ePoster Presenter(s)

  • Chia-Chi Lee

    Resident
    Far Eastern Memorial hospital
    NEw Taipei City, New Taipei, Taiwan (Republic of China)

    Disclosure information not submitted.

    View ePoster
All of the relevant financial relationships listed below have been mitigated.
Tai-Chuan Kuan, surgery: This individual has no financial relationships with ineligible companies.
Purpose/Background: Hemorrhoidal disease (HD) involves symptomatic vascular structures in the anal canal and is classified as internal hemorrhoid (IH), external hemorrhoid (EH), or mixed hemorrhoid (MH). Traditional hemorrhoidectomy, such as Milligan-Morgan hemorrhoidectomy (MMH), is effective but is associated with significant postoperative pain and complications. Laser hemorrhoidoplasty (LHP) offers a less invasive approach, reducing pain and recovery time, but is mainly effective for IH. This study compares the efficacy and complications of a combined approach—LHP for IH with external hemorrhoidectomy (LHP + EHD)—against MMH in treating MH.

Methods/Interventions: This study included 98 patients with MH who underwent either LHP + EHD or MMH at Far Eastern Memorial Hospital between March and August 2024. Outcomes were assessed using the BPRST (bleeding, prolapse, reduction, skin tag, thrombosis) classification for HD severity. The pain was measured using a visual analogue scale (VAS) at the first postoperative outpatient visit, and complications such as postoperative bleeding, acute urine retention, and infection were recorded. Statistical analyses were performed using chi-square tests, t-tests, and multivariate logistic regression.

Results/Outcomes: The LHP + EHD group had significantly lower VAS scores (1.87 ± 1.38) compared to the MMH group (2.79 ± 1.39), indicating less postoperative pain (P < 0.05). Both groups showed similar rates of bleeding and fistula formation, but the LHP + EHD group had a higher incidence of perineal infection (P < 0.05). In multivariate analysis, the surgical method (LHP + EHD vs. MMH) was a significant predictor of postoperative pain (P = 0.02).

Conclusion/Discussion: LHP + EHD results in less postoperative pain compared to MMH, but with a higher risk of perineal infection. It represents a promising alternative to MMH for treating MH, offering reduced pain with comparable complication rates.

Operation steps of laser hemorrhoidoplasty plus external hemorrhoidectomy ( LHP + EHD)
A: preoperative mixed hemorrhoid, B: Submucosal injection, C: Wedge incision over external hemorrhoid, D: remove external hemorrhoid (EHD), the white dot line is the border of the internal and external hemorrhoid. E: Laser hemorrhoidoplasty (LHP), the yellow arrow is the fiber of laser, F: status after LHP, G: Partial closure of the wound, H: Postoperative status