Abstract
Background and Purpose:
A new technique for the treatment of hemorrhoids is described using a 980-nm diode laser coupled with Doppler for photocoagulation of the distal branches of hemorrhoidal arteries. This painless, ambulatory treatment does not necessitate anesthesia or sedation and is based on the same principles as Doppler-guided ligation of the distal branches of hemorrhoidal arteries, a recent, innovative technique for the treatment of hemorrhoids achieving good results. Unfortunately, the latter technique requires local, general or epidural anesthesia, and ambulatory treatment is difficult.
Patients and Methods:
In the past 3 years, 200 patients were treated with Doppler-guided laser photocoagulation of hemorrhoidal arteries. In all cases, treatment was performed on an outpatient basis and anesthesia or analgesia was not necessary.
Results:
Mild intra- and postoperative complications were seen. 91% of the patients showed an improvement of hemorrhoidal symptoms 1–12 months after treatment.
Conclusion:
Doppler-guided laser photocoagulation of hemorrhoidal arteries is a good and safe method for the ambulatory treatment of hemorrhoids.
Zusammenfassung
Hintergrund und Ziel:
Beschrieben wird eine neue Technik zur Behandlung von Hämorrhoiden unter Verwendung eines 980-nm-Diodenlasers mit Doppler für die Photokoagulation der distalen Äste der Hämorrhoidalarterien. Es handelt sich um eine schmerzfreie ambulante Behandlung ohne Anästhesie oder Sedierung, die auf den gleichen Prinzipien wie die dopplerunterstützte Ligatur der distalen Äste der Hämorrhoidalarterien basiert, eine relativ neue Technik für die erfolgreiche Behandlung von Hämorrhoiden. Leider erfordert letztgenannte Technik eine Lokal-, Allgemein- oder Epiduralanästhesie, und eine ambulante Behandlung ist schwierig.
Patienten und Methodik:
In den letzten 3 Jahren wurden 200 Patienten einer dopplersonographisch unterstützten Hämoorhoidenarterien-Laserphotokoagulation unterzogen. Die Behandlung aller Patienten fand ambulant statt. Anästhesien oder Analgetika waren nicht notwendig.
Ergebnisse:
Es traten nur geringfügige intra- und postoperative Komplikationen auf. Bei 91% der Patienten kam es 1–12 Monate nach der Behandlung zu einer Besserung der Hämorrhoidensymptome.
Schlussfolgerung:
Die dopplersonographisch unterstützte Laserbehandlung von Hämorrhoidalarterien ist somit eine gute und sichere Methode zur ambulanten Behandlung von Hämorrhoiden.
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* Presented at the International Congress of Laser in Medicine and Surgery, Milan, Italy, September 12, 2008.
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Salfi, R. A New Technique for Ambulatory Hemorrhoidal Treatment. Coloproctol 31, 99–103 (2009). https://doi.org/10.1007/s00053-009-0009-7
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DOI: https://doi.org/10.1007/s00053-009-0009-7