Is co2 laser Hemorrhoidectomy superior to conventional open Hemorrhoidectomy?

Abstract

Background: Hemorrhoids are one of the most
common surgical conditions .Conventional
haemorrhoidectomy was the traditional operation for
the treatment of hemorrhoids. Other modalities of
treatment had been used as an alternative operations
including CO2 laser haemorrhoidectomy.
Objectives: To determine the outcome of treatment
of hemorrhoids by using CO2 laser
haemorrhoidectomy and its advantages over
conventional surgery
Methods: This is a retrospective comparative
interventional study of 1024 case of third degree
haemorhoids selected out of 1300 case of
hemorrhoids of different degrees, admitted to
ALKINDY, ALYERMOUK teaching hospitals and
ABD ALMAGEED private hospital, from May 1998
to July 2002,they were treated by CO2 laser
haemorrhoidectomy and conventional surgery. They
are divided into 2 groups randomly, 512 cases treated
by CO2 laser (group A), 512 cases treated by
conventional surgery (group B). Both groups were
studied regarding operative time, hospital stay,
healing time, post operative complications and cost
effectiveness.
Results: In GROUP A, the operative time ranged
from 10 to 20 minutes with an average of 13 minutes.
The hospital stay ranged from 4 to 12 hours with a
mean time of 10 hours as all cases were treated as
day cases. Post operative pain was minimal in 50% of
patients and required simple analgesia for treatment
while 50% had no pain. Bleeding occurred in less
than 1% of cases, anal stenosis 3.3%, Infection
recorded in 0.58% of patients.In GROUP B, The
operative time ranged from 15 to 25 minutes with an
average time of (19) minutes, hospital stay ranged
from 24 to 48 hours with a mean time of 28 hours
.Post operative pain recorded in all the patients
(100%) and required narcotic analgesia for treatment,
25 patients (4.8%) had varying degrees of bleeding,
40 patients (7.8%) had infection, 25 patients (4.8%)
had anal stenosis.In group A due to shorter hospital
stay, earlier healing of wounds, earlier return to work
which was within 7 to 10 days, the surgical treatment
proved to be cost effective