Laser hemorrhoidoplasty procedure versus harmonic scalpel hemorrhoidectomy: a comparative study for the treatment of grades III and IV hemorrhoids

Hemorrhoids are one of the most commonly presented diagnoses of colorectal diseases. This study aimed to evaluate and compare the outcomes of laser hemorrhoidoplasty (LHP) and harmonic scalpel hemorrhoidectomy (HSH) in the management of grades III and IV hemorrhoids, focusing on some postoperative complications. A randomized, controlled, clinical trial involving 34 patients with grades III and IV hemorrhoids was conducted at the General Surgery Department, Faculty of Medicine, Helwan University, from June 2022 to March 2023. Ethical considerations were adhered to, and patients provided informed consent. The groups underwent either LHP or HSH, and comprehensive patient information was collected, including demographics and preoperative assessments. Postoperative care and follow-up evaluations assessed outcomes such as pain, bleeding, discharge, wound healing, incontinence, recurrence, and stenosis. Demographic distribution was similar between the LHP and HSH groups, with comparable operative times. Postoperative bleeding did not significantly differ between groups. HSH was associated with more early discharge, longer wound healing times, and significantly higher postoperative pain levels up to the third week. No significant differences were observed in stenosis, incontinence, or recurrence between the two groups. Both HSH and LHP techniques were found to be safe and effective for managing hemorrhoids. LHP demonstrated advantages, including lower postoperative pain levels, reduced seromucous discharge, and faster wound healing compared with HSH. These findings provide valuable insights for clinicians in optimizing patient care during the management of hemorrhoids.