تحقیقات دکتر سعادتی

Evaluating the effect of CO2 laser
on hemorroidectomy

(A randomized clinical trial)
Laser Department of Milad
Hospital and privet clinic

Dr. Z.Saadati, Surgeon
Dr. S.Mokmeli, Anesthesiologist

***
Hemorrhoid
 Internal
 External

Internal hemorrhoid

 І
 Џ
 Ш
 ІV

Fissure: Linear ulcer in anal Canal
Laser: Co2- lo600 nm- Infrared

***

Aim of Study
The comparison between
Hemorrhoidectomy using
Co2 laser and without
That

***

Methods:

• 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 .

 

Control group
(Scalpel surgery) Case group
(laser surgery)
35 35 Mean age
25 25 Female
5 5 Male

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Evaluating parameters
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

***
Results:

 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

 

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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

Conclusion:
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.

Future planning:
 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

END
TANKS FOR ATTENTION

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