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Lasers in Medical Science
Published in: Lasers in Medical Science 3/2021

Open Access 01-04-2021 | Hemorrhoidectomy | Review Article

Non-excisional laser therapies for hemorrhoidal disease: a systematic review of the literature

Authors: Gregoire Longchamp, Emilie Liot, Jeremy Meyer, Christian Toso, Nicolas C. Buchs, Frederic Ris

Published in: Lasers in Medical Science | Issue 3/2021

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Abstract

Non-excisional laser therapies are emerging treatment for grades II and III hemorrhoidal disease (HD). However, so far, their efficiency is based on low-level evidence. Therefore, we aimed to systematically review the efficiency of non-excisional laser therapies for HD. MEDLINE/Pubmed, Web of science, Embase, and Cochrane were searched from database implementation until the April 17th, 2020. We included studies reporting at least one of surgical indicators of postoperative outcomes of laser therapies, encompassing laser hemorrhoidoplasty (LH) and hemorrhoidal laser procedure (HeLP). Fourteen studies describing LH and HeLP were included, representing 1570 patients. The main intraoperative complication was bleeding (0–1.9% of pooled patients for LH, 5.5–16.7% of pooled patients for HeLP). Postoperative complications occurred in up to 64% of patients after LH and 23.3% after HeLP. Resolution of symptoms ranged between 70 and 100% after LH and between 83.6 and 90% after HeLP. Moreover, four randomized controlled trials included in our review reported similar resolution after LH compared with hemorrhoidectomy or mucopexy and after HeLP compared with rubber band ligation. Recurrence rate was reported to range between 0 and 11.3% after LH and between 5 and 9.4% after HeLP. When compared with hemorrhoidectomy, LH showed conflicting results with one randomized controlled trial reporting similar recurrence rate, but another reporting decreased recurrences associated with hemorrhoidectomy. Laser therapies showed lower postoperative pain than hemorrhoidectomy or rubber band ligation. LH and HeLP are safe and effective techniques for the treatment of grades II and III HD.
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Metadata
Title
Non-excisional laser therapies for hemorrhoidal disease: a systematic review of the literature
Authors
Gregoire Longchamp
Emilie Liot
Jeremy Meyer
Christian Toso
Nicolas C. Buchs
Frederic Ris
Publication date
01-04-2021
Publisher
Springer London
Published in
Lasers in Medical Science / Issue 3/2021
Print ISSN: 0268-8921
Electronic ISSN: 1435-604X
DOI
https://doi.org/10.1007/s10103-020-03142-8

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