تحقیقات دکتر سعادتی
Evaluating the effect of CO2 laser
(A randomized clinical trial)
Laser Department of Milad
Hospital and privet clinic
Dr. Z.Saadati, Surgeon
Dr. S.Mokmeli, Anesthesiologist
Fissure: Linear ulcer in anal Canal
Laser: Co2- lo600 nm- Infrared
Aim of Study
The comparison between
Co2 laser and without
• Sixty patients with hemmorroid in 4 stage without fissure who didn't response to conservative management were operated in1387.
• Patients were allocated in 2 group ( n =30)
• In Case group Hemorrhoids and skin tags excised by CO2 laser. Laser was CO2-cw-12 w.
• In Control group Hemorrhoids and skin tags excised by scalpel.
• Surgeries were done for all of the patients by the same surgeon .
(Scalpel surgery) Case group
35 35 Mean age
25 25 Female
5 5 Male
The patients were visited regularly after the operation for 3 days and questioner forms were filled according to the following parameters:
pain ( was evaluated by verbal Analogue Scale:
No pain, mild, moderate, sever)
defecation pain (was evaluated by verbal Analogue Scale: No pain, mild, moderate, sever)
Bleeding (Yes, No)
Constipation (Yes, No)
inflammation edema( Yes, NO)
Erythematic (Yes, No)
Repair Low, moderate, good
Those patients who were operated with Co2 laser were under going less pain quite meaning fully.
Even nearly fifty percent of the patients didn't have any pain at all.
post operative bleeding was alleviated.
Constipation was not reduced meaningfully .
Although wound repairing seemed more acceptable and faster but statistically it wasn't meaningful
Results: (p< 0.01 is meaningful)
With Co2 Laser Without Laser Sig.
First Night Pain 80% Without Pain 53% Low Pain 0.003
First Day Pain 83% Without Pain 43% Low Pain 0.000
Second Day Pain 86% Without Pain 43% Without Pain 0.000
Third Day Pain 90% Without Pain 46% Without Pain 0.000
Pain Associated With Defecation 60% Without Pain 26% Without 0.001
Bleeding 90% Without 40% Without 0.004
Constipation 76% Without 76% Without 0.17
Inflammation 96% Without 83% Without 0.73
Repair 83% Good 80% Good 0.207
The results were analyses by spss program
Pain in the first night after the surgery and on the 2 following days was significantly reduced statistically in laser group.
Bleeding was significantly reduced statistically in laser group.
Pain in the first defecation was significantly reduced statistically in laser group.
There are no difference between the constipation, inflammation, erythema and healing time between the groups
Advantages of The Co2 Laser Surgery:
1- Pain Reduction.
2- Swelling Reduction.
3- Control of Infection.
4- Minimal Surgical Bleeding
Pain after hemorrhoid or fissure operation is the most important obsession of patients.
Pain after hemorrhoidectomy by co2 laser is very low and highly recommended.
There is a need to a big number of cases for more evaluating.
There is a need for comparing the effect of different radiation of laser mode ( pulse, continues) on the results.
There is a need for comparing the effect of different wave length of lasers on the results
TANKS FOR ATTENTION