The Efficacy of a Nd:YAG Laser in a Hemorrhoidectomy

Lim, Seok Won; Lee, Kwang Real; Hwang, Do Yean

Abstract

BACKGROUND
Even though lasers have been used in hemorrhoidectomies, there has been much debate about their effect. PURPOSE: A prospective randomized study was performed comparing the efficacy of a Nd:YAG laser with that of scalpel excision when performing a ligation excision, semi-closed hemorrhoidectomy.
METHODS
Sixty patients, who had more than three piles, with 3rd or 4th grade hemorrhoids, were enrolled into this study. Hemorrhoidectomies were performed under low spinal anesthesia. The ligation excision, semi-closed hemorrhoidectomy technique was used. Data evaluated included age, sex, operative time, postoperative pain scores, postoperative analgesic requirement, wound-healing time, and postoperative complications. Of the sixty patients enrolled into this study, 30 received laser excision and the other 30 scalpel excision.
RESULTS
There were no significant differences between the two groups, except for operative time (laser, 34.6 8.4 min; scalpel, 24.1 4.8 min). Postoperative complications, such as urinary retention, fecal impaction, skin tags, and postoperative fissure, were more common in the laser group.
CONCLUSIONS
A hemorrhoidectomy using a Nd:YAG laser takes longer than a conventional hemorrhoidectomy and neither reduces the postoperative pain nor shortens the wound-healing time. For achieving an effective treatment in hemorrhoids by using lasers, improved laser instruments are required, along with more detailed study of lasers and their effects.