The effects of laser procedure in symptomatic patients with haemorrhoids: A systematic review

Abstract

PurposeHaemorrhoids are normal structures in the human body, only seen as pathological when symptomatic. Nowadays, new techniques have surfaced using a diode laser which, after locating the target arteries, blocks the blood flow while hitting and shrinking the local mucosa/submucosa at a depth of 4 mm. Our work aimed to give a broad view over this new technique and its consequences in the post-operative follow-up with a systematic review.MethodsEMBASE and MEDLINE databases were consulted, retrieving clinical trials, which mentioned the use of 980 nm diode laser on the treatment of haemorrhoids.ResultsTen clinical trials analyzing the post-operative effects of laser haemorrhoidectomy were selected, including 2 randomized controlled clinical trials and 1 controlled clinical trial. The overall quality of the trials was low, indicating a high risk of bias.ConclusionThe laser haemorrhoidectomy procedure revealed a high therapeutic potential, considering the reduced number of postoperative complaints (bleeding/pain), the high symptom resolution and the reduced recurrence, albeit the high heterogeneity between the studies in terms of reported results. Future investigations with higher quality and controlled double-blinded studies obtaining better-categorized results should be conducted in order to better evaluate this procedure and compare it to the current paradigm.

Precision and Power: A Comprehensive Review of Exploring the Role of Laser Treatment in Hemorrhoidal Management

“…Long-term follow-up studies: While numerous studies have highlighted the positive outcomes of laser procedures for HD in the short to medium term, there is a pressing need for additional long-term follow-up studies. These studies would evaluate the durability of symptom resolution, recurrence rates, and potential late complications associated with laser treatments [35][36][37].…”

“…Comparative studies: More comparative studies are necessary to directly contrast the efficacy, safety, and long-term outcomes of laser procedures like LHP and HeLP with traditional surgical methods such as hemorrhoidectomy or RBL. These investigations could offer valuable insights into the optimal treatment approach for different grades of HD [35][36][37].…”

“…Patient-reported outcomes: Future research could focus on integrating patient-reported outcome measures to evaluate factors like quality of life, treatment satisfaction, and the impact on daily activities following laser procedures for HD. Understanding patient perspectives can aid in tailoring treatments to individual needs and enhancing overall patient care [35][36][37].…”

“…Optimal patient selection: Investigating the criteria for selecting patients who would benefit most from laser treatments, including factors such as the severity of hemorrhoids, rectal prolapse, and other individual characteristics, could refine treatment guidelines and enhance patient outcomes [35][36][37].…”

“…Technological advancements: Research efforts toward advancements in laser technology, such as Doppler-guided procedures and selective closure of hemorrhoidal arteries, could further refine the precision, efficacy, and safety of laser treatments for HD. Exploring novel techniques and tools may improve outcomes and decrease complications [ 36 , 37 ].…”