Hemorrhoidal disease is a prevalent anorectal condition causing significant morbidity,affecting approximately 4%of the general population with incidence increasing with age and sedentary lifestyle.While conventional e...Hemorrhoidal disease is a prevalent anorectal condition causing significant morbidity,affecting approximately 4%of the general population with incidence increasing with age and sedentary lifestyle.While conventional excisional hemorrhoidectomy techniques such as Milligan-Morgan and Ferguson remain standard for long-term efficacy,they are often associated with substantial postoperative pain and prolonged recovery.This narrative review evaluates the comparative clinical outcomes of laser hemorrhoidoplasty(LHP)versus conventional surgical interventions in the treatment of grade II and III symptomatic hemorrhoids.A comprehensive analysis of comparative studies,randomized controlled trials,and meta-analyses published between 2020 and 2025 was conducted,with primary outcomes including postoperative pain,recovery time,operative duration,complication rates,and recurrence.Key findings from studies by Maloku et al and Hassan et al.were analyzed to contextualize real-world LHP use.Across multiple high-quality studies,LHP was consistently associated with significantly lower postoperative pain scores,reduced analgesic requirements,and faster return to daily activities.Maloku et al demonstrated a shorter mean operative time(15.9 minutes)and reduced pain compared to open techniques(26.8 minutes;P<0.01).Hassan et al confirmed these benefits in a cohort of 40 patients treated under local anesthesia.Operative time was generally comparable or shorter,and vessel ligation was suggested as an adjunct to improve outcomes in select cases.Complication rates were low and similar between groups,with LHP demonstrating minimal risk for major complications such as anal stenosis or incontinence.However,recurrence rates were higher with LHP in some studies,particularly in grade III disease.LHP offers a minimally invasive,low-morbidity alternative to excisional hemorrhoidectomy for appropriately selected patients.Despite superior short-term recovery profiles,potential for higher recurrence underscores the importance of patient selection and long-term follow-up.The role of local anesthesia and adjunctive vessel ligation merits further prospective evaluation.展开更多
BACKGROUND Stapled hemorrhoidopexy(SH)is one of the most commonly used surgical techniques for hemorrhoidal disease,being particularly effective for grade III and IV hemorrhoids.The procedure is associated with better...BACKGROUND Stapled hemorrhoidopexy(SH)is one of the most commonly used surgical techniques for hemorrhoidal disease,being particularly effective for grade III and IV hemorrhoids.The procedure is associated with better short-term outcomes,including less postoperative pain,shorter operative time,faster return to work,and higher patient satisfaction.However,there is a risk-benefit debate surrounding SH due to significant complications from the procedure,such as anal stenosis,rectovaginal fistula,fecal incontinence,and recurrence.AIM To evaluate recurrence rates and factors influencing surgical outcomes following SH in patients with grade III and IV hemorrhoids.METHODS This retrospective,single-center study enrolled a total of 77 patients with grade III/IV hemorrhoids for analysis.Early(less than 7 days after SH)and late(7 or more days after SH)complications were analyzed.Recurrence rates were calculated as well.RESULTS Patients were categorized by hemorrhoid grade and showed no differences in demographic data between the two groups.Recurrence was observed in 4 patients(23.6%)with grade IV hemorrhoids,and no recurrence was noted in patients with grade III hemorrhoids.Postoperative bleeding,incomplete defecation,urgent defecation,incontinence,skin tags,and anal fissure were complications reported by both groups.CONCLUSION Due to the high recurrence rate,SH is not an appropriate treatment option for patients with grade IV hemorrhoids.Open surgery may be a more suitable option for these patients.展开更多
文摘Hemorrhoidal disease is a prevalent anorectal condition causing significant morbidity,affecting approximately 4%of the general population with incidence increasing with age and sedentary lifestyle.While conventional excisional hemorrhoidectomy techniques such as Milligan-Morgan and Ferguson remain standard for long-term efficacy,they are often associated with substantial postoperative pain and prolonged recovery.This narrative review evaluates the comparative clinical outcomes of laser hemorrhoidoplasty(LHP)versus conventional surgical interventions in the treatment of grade II and III symptomatic hemorrhoids.A comprehensive analysis of comparative studies,randomized controlled trials,and meta-analyses published between 2020 and 2025 was conducted,with primary outcomes including postoperative pain,recovery time,operative duration,complication rates,and recurrence.Key findings from studies by Maloku et al and Hassan et al.were analyzed to contextualize real-world LHP use.Across multiple high-quality studies,LHP was consistently associated with significantly lower postoperative pain scores,reduced analgesic requirements,and faster return to daily activities.Maloku et al demonstrated a shorter mean operative time(15.9 minutes)and reduced pain compared to open techniques(26.8 minutes;P<0.01).Hassan et al confirmed these benefits in a cohort of 40 patients treated under local anesthesia.Operative time was generally comparable or shorter,and vessel ligation was suggested as an adjunct to improve outcomes in select cases.Complication rates were low and similar between groups,with LHP demonstrating minimal risk for major complications such as anal stenosis or incontinence.However,recurrence rates were higher with LHP in some studies,particularly in grade III disease.LHP offers a minimally invasive,low-morbidity alternative to excisional hemorrhoidectomy for appropriately selected patients.Despite superior short-term recovery profiles,potential for higher recurrence underscores the importance of patient selection and long-term follow-up.The role of local anesthesia and adjunctive vessel ligation merits further prospective evaluation.
文摘BACKGROUND Stapled hemorrhoidopexy(SH)is one of the most commonly used surgical techniques for hemorrhoidal disease,being particularly effective for grade III and IV hemorrhoids.The procedure is associated with better short-term outcomes,including less postoperative pain,shorter operative time,faster return to work,and higher patient satisfaction.However,there is a risk-benefit debate surrounding SH due to significant complications from the procedure,such as anal stenosis,rectovaginal fistula,fecal incontinence,and recurrence.AIM To evaluate recurrence rates and factors influencing surgical outcomes following SH in patients with grade III and IV hemorrhoids.METHODS This retrospective,single-center study enrolled a total of 77 patients with grade III/IV hemorrhoids for analysis.Early(less than 7 days after SH)and late(7 or more days after SH)complications were analyzed.Recurrence rates were calculated as well.RESULTS Patients were categorized by hemorrhoid grade and showed no differences in demographic data between the two groups.Recurrence was observed in 4 patients(23.6%)with grade IV hemorrhoids,and no recurrence was noted in patients with grade III hemorrhoids.Postoperative bleeding,incomplete defecation,urgent defecation,incontinence,skin tags,and anal fissure were complications reported by both groups.CONCLUSION Due to the high recurrence rate,SH is not an appropriate treatment option for patients with grade IV hemorrhoids.Open surgery may be a more suitable option for these patients.
