Treatment of advanced hemorrhoidal disease: A prospective, randomized comparison of cold scalpel vs. contact Nd:YAG laser

Anthony Senagore, W. Patrick Mazier, Martin A. Luchtefeld, John M. MacKeigan, Timothy Wengert

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    70 Scopus citations

    Abstract

    PURPOSE: Recently, laser technology has been advocated for the treatment of hemorrhoids. However, there has been little scientific evaluation of the use of the Nd:YAG laser for excisional treatment of hemorrhoidal disease. The purpose of this study was to perform a prospective randomized study of the Nd:YAG laservs.scalpel excision, when performing a standard Ferguson-closed hemorrhoidectomy. METHODS: Patients presenting for internal-external hemorrhoidectomy were eligible for study. Hemorrhoidectomies were performed under epidural or caudal blocks. The standard Ferguson closed hemorrhoidectomy technique was used. Data evaluated included: age, sex, estimated blood loss, operative time, postoperative pain scores, postoperative analgesic use, wound healing, and time for return to work. Eighty-six patients were eligible for study (laser, N=51; scalpel, N=35). RESULTS: There were no significant differences between the groups, except for a greater degree of wound inflammation and dehiscence at the 10 day postoperative visit for the laser group (laser, 1.7±.2; scalpel, 0.8±.2;P<0.05, t-test). The use of the Nd:YAG laser added $480 per case; as a result, the treatment cost for the laser group was $15,360 higher than that of the conventional group. CONCLUSION: The results indicate that there are no patient care advantages associated with the use of the Nd:YAG laser for excisional hemorrhoidectomy compared with scalpel excision. As new technology becomes available, surgeons must rigorously assess therapeutic efficacy and cost-benefit ratio before deciding to employ this technology for patient care.

    Original languageEnglish (US)
    Pages (from-to)1042-1049
    Number of pages8
    JournalDiseases of the Colon & Rectum
    Volume36
    Issue number11
    DOIs
    StatePublished - Nov 1 1993

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    Keywords

    • Ferguson hemorrhoidectomy
    • Hemorrhoidectomy
    • Nd:YAG laser

    ASJC Scopus subject areas

    • Gastroenterology

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