LASER SUBMUCOSAL DESTRUCTION OF CHRONIC HEMORRHOIDS STAGE II-III
AIM: to evaluate the effecacy of laser submucosal destruction using a radial light guide in patients with chronic hemorrhoids (stages II and III). PATIENTS AND METHODS: the study included 65 patients with chronic hemorrhoids, 20% had stage II and 80% - stage III by Goligher classification. Laser submucosal destruction of hemorrhoidal piles has been performed in all patients. The following criteria of assessment were used: pain intensity by visual analogue pain (VAS) scale, the morbidity rate and the time complete wounds healing. Criteria for late results assessment was the severity of the main symptoms of hemorrhoidal disease like piles prolapse, bleeding, thrombosis and anal itching. RESULTS: in 54 (83.1%) patients the postoperative period was uneventful. Postoperative pain syndrome was 3±2 points on VAS scale. Minor postoperative complications were detected in 11 (16.9%) patients. No recurrent hemorrhoids occurred in follow-up. CONCLUSION: laser submucosal destruction is a good alternative for HAL-RAR and STARR procedure for hemorrhoidal disease, when the rubber band ligation and sclerotherapy were ineffective but the time for classical hemorrhoidectomy has not yet come.