대한대장항문학회

Background : Even though lasers have been used in hemorrhoidectomies, there has been<br>much debate about their effect. Purpose : A prospective randomized study was performed<br>comparing the efficacy of a Nd:YAG laser with that of scalpel excision when performing a<br>ligation excision, semi-closed hemorrhoidectomy. Methods : Sixty patients, who had more<br>than three piles, with 3rd or 4th grade hemorrhoids, were enrolled into this study. Hemorr<br>hoidectomies were performed under low spinal anesthesia. The ligation excision, semi- closed<br>hemorrhoidectomy technique was used. Data evaluated included age, sex, operative time,<br>postoperative pain scores, postoperative analgesic requirement, wound- healing time, and<br>postoperative complications. Of the sixty patients enrolled into this study, 30 received laser<br>excision and the other 30 scalpel excision. Results : There were no significant differences<br>between the two groups, except for operative time (laser, 34.6 8.4 min; scalpel, 24.1 4.8<br>min). Postoperative complications, such as urinary retention, fecal impaction, skin tags, and<br>postoperative fissure, were more common in the laser group. Conclusions : A<br>hemorrhoidectomy using a Nd:YAG laser takes longer than a conventional hemorrhoi<br>dectomy and neither reduces the postoperative pain nor shortens the wound- healing time.<br>For achieving an effective treatment in hemorrhoids by using lasers, improved laser instru<br>ments are required, along with more detailed study of lasers and their effects.<br>