The Clinical Efficacy of Infrared Photocoagulation Versus Closed Hemorrhoidectomy in Treatment of Hemorrhoid

Abstract

Introduction: Infrared photocoagulation (IRC) was introduced as a mainstay procedure for treatment of hemorrhoids. The present study aimed to compare the clinical efficacy of IRC compared to closed hemorrhoidectomy. Methods: Forty patients suffering grade-3 hemorrhoid that referred to the surgery clinic at Imam Hossein hospital in Tehran in 2013 were randomly assigned to groups treated with the IRC modality or Ferguson's closed hemorrhoidectomy method. The patients in the 2 groups were followed-up for the first 24 hours after surgery and 8 weeks later. Postoperative pain was assessed using visual analogue scale (VAS) at three time points of 24 hours, 2 weeks and 8 weeks after operation. Results: Regarding bleeding, its overall prevalence was 5.0% in the IRC group and 30.0% in the hemorrhoidectomy group, which was significantly less prevalent in the IRC group. Notably, the IRC group had a lower mean postoperative pain score compared to the hemorrhoidectomy group. Time of return to work was significantly shorter in the IRC group; no difference was found in the mean duration of hospital stay, and recurrence rate across 2 groups. Conclusion: IRC procedure is safer than closed hemorrhoidectomy with lower postoperative pain severity, less secondary bleeding, and leads to earlier return to work in patients with hemorrhoid.

Indirect Coagulation of Residual Lesions of Circumferential Piles after Excisional Hemorrhoidectomy; a Prospective Controlled Pilot Study

“…The result was no case of major bleeding in the study group. This is the same principle upon which the infrared photocoagulation technique is based, 9 but at much lower costs utilizing the already available resources. The coagulated columns retract upwards repositing the residual lesions within the anal canal (The anal mucosa sliding theory of hemorrhoids pathogenesis).…”

“…However, high price of its equipment may limit its application. 9 In this technique, infrared light is used to induce thrombosis and scarring of the hemorrhoidal plexus, 10 generating sclerosis and fixation of hemorrhoids. 9 Trying to deal with the residual lesions in cases of circumferential piles after surgical hemorrhoidectomy using the same principles of infrared photocoagulation at affordable costs and available resources, we introduce the technique of "indirect coagulation" of lesions remaining after open excisional hemorrhoidectomy in patients with circumferential mixed piles.…”

Comparison of Laser Hemorrhoidoplasty and Milligan-Morgan Hemorrhoidectomy Techniques in the Treatment of Grade 2 and 3 Hemorrhoidal Disease

“…Although the literature indicates that the recurrence rates after laser treatment are relatively low, no significant difference is noted when compared to conventional hemorrhoidectomy procedures. 12,13,28,29 Since the early postoperative results were evaluated in our study and some patients did not have long-term results, data on recurrence could not be obtained yet.…”

Hemorrhoidal Disease: How to Proceed After Unsuccessful Medical Treatment?

“…When comparing IRC to hemorrhoidectomy, one researcher found that patients in the IRC group saw a prevalence of bleeding that was only 5%. In contrast, patients in the hemorrhoidectomy group experienced a prevalence of bleeding that was 30% [62]. Also, one of the advantages of IRC is that it is a quick and convenient outpatient procedure that can be performed in an office setting.…”

“…IRC has been demonstrated to be more effective in reducing post-procedural pain than other treatment methods. Patients who had IRC had much less pain in the immediate time after treatment, compared to those who underwent standard hemorrhoidectomy, according to prospective research that compared the two procedures [62,63].…”