Comparison of Laser Haemorrhoidoplasty and Ferguson Haemorrhoidectomy in Treating Grade III and Grade IV Haemorrhoids: A Prospective Randomised Study.

Objective: To compare the efficiency and safety of laser haemorrhoidoplasty (LH) with Ferguson haemorrhoidectomy (FH) in patients with third- and fourth-grade haemorrhoids.

Study Design: Randomised controlled trial.

Place And Duration Of Study: General Surgery Clinic, Medipol University Pendik Hospital, İstanbul, Turkey, from 1st December 2021 to 1st May 2022.

Methodology: The patients who had an indication for surgery for grade III or grade IV haemorrhoidal disease (HD) and who were 18 years and older were randomly allocated to the two study groups. While LH was performed using a 980-diode laser in the patients enrolled in the laser group, a standard FH was performed using diathermy in the patients in the second study group. The length of surgery (LOS), the number of excised lumps, wound healing time, time to symptom relief, pre- and postoperative Visual Analogue Scale (VAS) scores and the difference between them (Δ VAS), and complication rates were compared between two study groups.

Results: LH had less LOS with a similar number of excised lumps, furthermore, it provided faster-wound healing and less time-to-symptom relief when compared to FH. The median VAS score decreased from 5 to 0 in the LH group and from 5 to 2 in FH, and Δ VAS scores of the groups were statistically significantly different (p<0.001). LH also had better outcomes than FH in terms of having any type of postoperative complication.

Conclusion: LH might be an alternative treatment modality in patients with grade III and grade IV HD with a low level of complication rate.

Key Words: Haemorrhoids, Laser therapy, Haemorrhoidectomy, Operative time, Pain measurement, Postoperative complications.