| Abstract [eng] |
Introduction. Haemorrhoids are the most common anorectal disease, affecting about one third of the adult population. Due to the high prevalence of symptomatic haemorrhoids, alternative interventional treatments for haemorrhoids are being considered. The aim of this study is to compare 3 methods of haemorrhoid treatment for grade II-III haemorrhoids (open haemorrhoidectomy, hamorrhoidal pedicle ligation, laser hemorrhoidoplasty) and to evaluate the late results of the different treatment methods. Materials and methods. This is a single-centre, randomized, double-blind study conducted at Vilnius University Hospital Santaros Clinics. The study included 121 patients who were divided into 3 groups based on a randomly selected method of surgery: group I – open haemorrhoidectomy, group II – hamorrhoidal pedicle ligation, group III – laser hemorrhoidoplasty. Subjects were interviewed remotely using the surgery examination protocol, the SF-36 quality of life questionnaire, the incontinence and quality of life questionnaire, the Wexner scale, and the regret of surgery questionnaire. Results. 121 subjects participated in the study. The survey was conducted at a mean of 66 months after surgery. The recurrence rate was 20% in group I, 37% in group II and 25% in group III (p=0.23). Reoperation was required in 1 group III and 2 group II patients, whereas no reoperation was required in group I. The intensity and frequency of haemorrhoidal bleeding was similar between groups (p>0.05). The number of recurrent haemorrhoids was lowest in group I, whereas in group II IIº-IVº haemorrhoids recurred significantly more times (p= 0.04). The incidence of haemorrhoidal node prolapse was similar (p= 0.33). Fecal incontinence was similar between groups (p= 0.22). Quality of life scores were similar between groups (p>0.05). Patients in group II had the best evaluation of the surgery, while those in group III had the worst (p= 0.04). The results of the decision regret questionnaire for the procedure did not reveal a significant difference between the groups (p= 0.19). Conclusions. The most effective procedure for the treatment of second- and third-degree haemorrhoids is excisional haemorrhoidectomy followed by laser hemorrhoidoplasty and hamorrhoidal pedicle ligation. |
