Our Summary

This research paper looks at two different surgical treatments for hemorrhoids, a common and painful condition. The standard treatment has been surgical removal of the hemorrhoids, but this can cause a lot of pain after surgery, bleeding, and long recovery times. Two newer treatments are laser surgery and a method called LigaSure. The researchers wanted to compare these two methods.

They looked back at the records of patients who had either laser surgery or LigaSure, and they measured things like how much pain the patients felt after surgery, any complications they had, whether the hemorrhoids came back, and how long it took them to return to work.

The results showed that patients who had laser surgery had less pain after surgery and less bleeding during the surgery. However, they were more likely to have the hemorrhoids come back compared to the patients who had LigaSure. They were also able to return to work and normal activities sooner than the LigaSure patients.

In conclusion, the researchers suggest that laser surgery could be a good option for patients with grade II-III hemorrhoids, as it causes less pain and allows for quicker recovery. However, the higher risk of the hemorrhoids returning is a downside. They suggest that future research should look at whether combining laser surgery with other treatments could be beneficial.

FAQs

  1. What are the two newer surgical treatments for hemorrhoids mentioned in the research paper?
  2. How do the after-effects of laser surgery and LigaSure for hemorrhoids compare in terms of pain, bleeding, recovery time, and recurrence?
  3. What are the conclusions and suggestions of the researchers regarding the use of laser surgery for treating grade II-III hemorrhoids?

Doctor’s Tip

A helpful tip a doctor might give a patient about hemorrhoidectomy is to discuss with their surgeon the different surgical options available, such as laser surgery and LigaSure, to determine which one may be the best choice based on their individual situation. It is important to weigh the potential benefits and risks of each option and consider factors such as pain levels, recovery time, and likelihood of hemorrhoid recurrence. Additionally, following post-operative care instructions and maintaining good bowel habits can help promote healing and reduce the risk of complications.

Suitable For

Overall, patients who are typically recommended for hemorrhoidectomy are those with severe or persistent symptoms of hemorrhoids that do not respond to non-surgical treatments such as dietary changes, fiber supplements, and over-the-counter medications. These patients may have grade II-III hemorrhoids, which are larger and more symptomatic, or grade IV hemorrhoids, which are prolapsed and require surgical intervention.

Additionally, patients who have recurrent hemorrhoids or complications such as thrombosis or excessive bleeding may also be recommended for hemorrhoidectomy. It is important for patients to discuss their symptoms and treatment options with a healthcare provider to determine the most appropriate course of action for their individual case.

Timeline

Before hemorrhoidectomy:

  1. Patient experiences symptoms of hemorrhoids such as pain, itching, bleeding, and discomfort.
  2. Patient may try conservative treatments such as over-the-counter medications, dietary changes, and lifestyle modifications to alleviate symptoms.
  3. If conservative treatments are not effective, patient may consult with a healthcare provider who may recommend surgical removal of the hemorrhoids.
  4. Patient undergoes preoperative evaluation and preparation for surgery.

After hemorrhoidectomy:

  1. Patient undergoes hemorrhoidectomy surgery, either through traditional surgical removal, laser surgery, or LigaSure.
  2. Postoperatively, patient may experience pain, discomfort, and bleeding at the surgical site.
  3. Patient is prescribed pain medications and instructed on wound care and hygiene to promote healing.
  4. Patient may experience temporary changes in bowel habits and may need to follow a special diet to prevent constipation.
  5. Patient is advised to avoid strenuous activities and heavy lifting during the recovery period.
  6. Follow-up appointments with the healthcare provider are scheduled to monitor healing and address any complications.
  7. Patient gradually resumes normal activities and may return to work once cleared by the healthcare provider.
  8. Patient continues to follow up with the healthcare provider for long-term management of hemorrhoids and to monitor for recurrence.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hemorrhoidectomy include:

  1. What are the potential risks and complications associated with hemorrhoidectomy surgery?
  2. How long is the recovery time after hemorrhoidectomy surgery?
  3. Will I experience a lot of pain after the surgery, and what can I do to manage it?
  4. What type of anesthesia will be used during the surgery?
  5. What is the success rate of the specific type of hemorrhoidectomy surgery being recommended?
  6. How likely are the hemorrhoids to come back after the surgery?
  7. Are there any alternative treatments to hemorrhoidectomy that I should consider?
  8. How soon after the surgery can I return to work and normal activities?
  9. Will I need to make any changes to my diet or lifestyle after the surgery?
  10. Are there any long-term effects or complications I should be aware of following the surgery?

Reference

Authors: Tümer H, Ağca MH. Journal: ANZ J Surg. 2023 Jul-Aug;93(7-8):1885-1889. doi: 10.1111/ans.18568. Epub 2023 Jun 13. PMID: 37312422