Staff View: Clinical short-term outcomes of laser hemorrhoidoplasty: A multicenter study

Clinical short-term outcomes of laser hemorrhoidoplasty: A multicenter study

Background: Laser hemorrhoidoplasty (LHP) is a treatment for symptomatic internal hemorrhoids. Nevertheless, there are disparities in the technique employed, including combining it with pedicle ligation. We aimed to investigate if short-term clinical outcomes were different between patients undergoi...

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Main Authors:	Chong, H.Y., Roslani, April Camilla, Rajandram, Retnagowri, Kumar, S., Malik, A.A., Law, C.W., Chan, S.H., Rajasingam, V., Kasipillai, J.
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Published:	Faculty of Medicine, University of Malaya 2022
Subjects:	RC Internal medicine RD Surgery
Online Access:	http://eprints.um.edu.my/43860/
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spelling	my.um.eprints.438602023-12-05T02:37:23Z http://eprints.um.edu.my/43860/ Clinical short-term outcomes of laser hemorrhoidoplasty: A multicenter study Chong, H.Y. Roslani, April Camilla Rajandram, Retnagowri Kumar, S. Malik, A.A. Law, C.W. Chan, S.H. Rajasingam, V. Kasipillai, J. RC Internal medicine RD Surgery Background: Laser hemorrhoidoplasty (LHP) is a treatment for symptomatic internal hemorrhoids. Nevertheless, there are disparities in the technique employed, including combining it with pedicle ligation. We aimed to investigate if short-term clinical outcomes were different between patients undergoing LHP with and without pedicle. Methods: Patients who underwent LHP from a prospective registry of 3 centers were identified. Demographics, severity, symptoms, operative technique, post-operative pain, complications, and recurrence were investigated. Sub-investigation of patients with simultaneous pedicle ligation, and without, was performed. Statistical analysis was done using the χ2 test. P values <0.05 were noted as statistically significant. Results: One hundred and two patients (59.8 male) of a mean age of 45 years were assessed. Most (62.7) had 3rd degree hemorrhoids. Median operative time was 24 minutes (10-60 minutes) minutes. Post-operative length of stay was 26 hours (2-168 hours) hours. Median pain score 24 hours post-operatively was 0/10. The general complication percentage was 26.5, but majority complications were self-limiting. The most common complication was post-operative swelling (16 patients; 15.7). Post-operative bleeding was seen in 9 patients (8.8) at a median of 7 (1-14) days, 3 of whom needed operation and readmission. Then 4 patients (3.9) had moderate-to-severe pain (pain score of more than 5/10), 2 patients (2.0) developed ulceration and 3 patients (2.9) had recurrence, were treated conservatively. Patients with pedicle ligation had a higher complication (33.3 vs. 14.8; p=0.08), mainly bleeding and swelling but not statistically significant. Conclusions: LHP demonstrates good short-term outcomes with minimal complication and recurrence incidences. Supplementary ligation of pedicles does not provide additional benefits, and in fact, may worsen outcomes. © 2022, Faculty of Medicine, University of Malaya. All rights reserved. Faculty of Medicine, University of Malaya 2022 Article PeerReviewed Chong, H.Y. and Roslani, April Camilla and Rajandram, Retnagowri and Kumar, S. and Malik, A.A. and Law, C.W. and Chan, S.H. and Rajasingam, V. and Kasipillai, J. (2022) Clinical short-term outcomes of laser hemorrhoidoplasty: A multicenter study. Journal of Health and Translational Medicine, 25 (2). 73 -78. ISSN 18237339, DOI https://doi.org/10.22452/jummec.vol25no2.12 <https://doi.org/10.22452/jummec.vol25no2.12>. 10.22452/jummec.vol25no2.12
institution	Universiti Malaya
building	UM Library
collection	Institutional Repository
continent	Asia
country	Malaysia
content_provider	Universiti Malaya
content_source	UM Research Repository
url_provider	http://eprints.um.edu.my/
topic	RC Internal medicine RD Surgery
spellingShingle	RC Internal medicine RD Surgery Chong, H.Y. Roslani, April Camilla Rajandram, Retnagowri Kumar, S. Malik, A.A. Law, C.W. Chan, S.H. Rajasingam, V. Kasipillai, J. Clinical short-term outcomes of laser hemorrhoidoplasty: A multicenter study
description	Background: Laser hemorrhoidoplasty (LHP) is a treatment for symptomatic internal hemorrhoids. Nevertheless, there are disparities in the technique employed, including combining it with pedicle ligation. We aimed to investigate if short-term clinical outcomes were different between patients undergoing LHP with and without pedicle. Methods: Patients who underwent LHP from a prospective registry of 3 centers were identified. Demographics, severity, symptoms, operative technique, post-operative pain, complications, and recurrence were investigated. Sub-investigation of patients with simultaneous pedicle ligation, and without, was performed. Statistical analysis was done using the χ2 test. P values <0.05 were noted as statistically significant. Results: One hundred and two patients (59.8 male) of a mean age of 45 years were assessed. Most (62.7) had 3rd degree hemorrhoids. Median operative time was 24 minutes (10-60 minutes) minutes. Post-operative length of stay was 26 hours (2-168 hours) hours. Median pain score 24 hours post-operatively was 0/10. The general complication percentage was 26.5, but majority complications were self-limiting. The most common complication was post-operative swelling (16 patients; 15.7). Post-operative bleeding was seen in 9 patients (8.8) at a median of 7 (1-14) days, 3 of whom needed operation and readmission. Then 4 patients (3.9) had moderate-to-severe pain (pain score of more than 5/10), 2 patients (2.0) developed ulceration and 3 patients (2.9) had recurrence, were treated conservatively. Patients with pedicle ligation had a higher complication (33.3 vs. 14.8; p=0.08), mainly bleeding and swelling but not statistically significant. Conclusions: LHP demonstrates good short-term outcomes with minimal complication and recurrence incidences. Supplementary ligation of pedicles does not provide additional benefits, and in fact, may worsen outcomes. © 2022, Faculty of Medicine, University of Malaya. All rights reserved.
format	Article
author	Chong, H.Y. Roslani, April Camilla Rajandram, Retnagowri Kumar, S. Malik, A.A. Law, C.W. Chan, S.H. Rajasingam, V. Kasipillai, J.
author_facet	Chong, H.Y. Roslani, April Camilla Rajandram, Retnagowri Kumar, S. Malik, A.A. Law, C.W. Chan, S.H. Rajasingam, V. Kasipillai, J.
author_sort	Chong, H.Y.
title	Clinical short-term outcomes of laser hemorrhoidoplasty: A multicenter study
title_short	Clinical short-term outcomes of laser hemorrhoidoplasty: A multicenter study
title_full	Clinical short-term outcomes of laser hemorrhoidoplasty: A multicenter study
title_fullStr	Clinical short-term outcomes of laser hemorrhoidoplasty: A multicenter study
title_full_unstemmed	Clinical short-term outcomes of laser hemorrhoidoplasty: A multicenter study
title_sort	clinical short-term outcomes of laser hemorrhoidoplasty: a multicenter study
publisher	Faculty of Medicine, University of Malaya
publishDate	2022
url	http://eprints.um.edu.my/43860/
_version_	1784586076487155712
score	13.211869

Clinical short-term outcomes of laser hemorrhoidoplasty: A multicenter study

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