350 ambulatory hemorrhoidectomies using a scanner coupled to a CO2 laser

The purpose of this study was to investigate how a scanner device would imp rove the outcome of laser hemorrhoidectomy regarding pain, healing, secreti on, and hemostasis, Background Data: The technology of the laser has been a pplied since the 1960s in several clinical and surgical specialties. The in herent advantages, due to the biological characteristics of this instrument are: (1) it does not affect the neighborning tissues, (2) it is hemostatic , (3) it favors healing, (4) it is bactericidal, and (5) it presents less p ostoperative pain. Several authors have questioned these supposed advantage s, After scanners were introduced, better results were accomplished, includ ing in proctological surgery. Methods: A total of 350 patients, consecutive ly, went through a laser hemorrhoidectomy using a CO2 laser coupled to a sc anner device in a 3-year period. Patients were monitored for pain, healing, bleeding, and local secretion for up to 36 months. Results: Almost 13% of the patients required bondage of arteries during the operation; 96% used an algesics for up to 3 days; and 5 patients (1.42%) complained of strong pain for several days, Only 2 patients (0.6%) reported intense pain for more th an 7 days. All patients presented complete healing between the 30th and the 40th POD. In the 90th POD tissue regeneration appeared healthy. The immedi ate complications included 2 cases of nipple hemorrhage that demanded a rev iew. Stenosis occurred in 4 patients, Residual "plicoma" was often present with the laser technique (20%), Return to work, regardless of its nature, w as an average, on the 3rd postoperative day. Conclusions: Our evaluation of the results led to the conclusion that the scanner coupled to the CO2 lase r was fundamental for better postoperative outcome in our patients, at leas t compared to other laser techniques.