Comparsion of Two Methods in the Surgical Treatment of Grade III Internal Hemorrhoid: Closed Hemorrhoidectomy (Ferguson) versus Laser Therapy

Introduction & Surgical therapy is still useful and preferred for patients with large third-degree or fourth-degree hemorrhoids. One of the novel methods in the surgical treatment of hemorrhoid is laser therapy. The aim of this study is to evaluate the outcome of closed hemorrhoidectomy versus laser therapy. In this study, 56 patients with internal hemorrhoids of grade III, who were admitted to the hospital, were divided randomly into two groups, each one containing 28 patients. The first group were treated by using laser hemorrhoidectomy and the other group underwent the Ferguson closed hemorrhoidectomy. Visual pain score and complications such as bleeding, urine retention, anal stricture, gas and fecal incontinence and infection were compared in the two groups. The data in questionnaire and forms were analyzed with SPSS software and descriptive statistics and if needed statistical tests of T-test and chi- square test was done, and if needed accurate Fisher test was used. A P-value of less than 0.05 was considered as statistical significance level. There was no significant difference between age and sex in the two groups. Visual pain score in laser hemorrhoidectomy in the first 24 hours (1.42 ± 1.57) and during the first week (0.49 ± 0.39) was significantly less than the case of closed hemorrhoidectomy group (respectively 1.91 ± 2.57 and 0.58 ± 0.75). Except in the cases of bleeding, which was considered to be significantly lower in laser therapy than control group, the difference between the two groups was not significant as far as other complications is concerned. The two groups did not differ in duration of surgery. However, the cost of laser hemorrhoidectomy group was significantly higher (P< 0.001). Despite higher costs, laser treated hemorrhoidectomy patients experienced less pain than the standard hemorrhoidectomy patients. So, we suggested laser therapy as the preferable method in treating hemorrhids.