Torrinha Gonçalo, Gonçalves Tatiana, Sousa Maria, Högemann Gerrit, Goulart André, Carvalho Alexandre Fernandes, Leão Pedro
Life and Health Sciences Research Institute (ICVS), Medical School, University of Minho, Braga, Portugal.
General Surgery Department, Hospital Privado de Braga, Grupo Trofa Saúde, Braga, Portugal.
Front Surg. 2022 Dec 12;9:1050515. doi: 10.3389/fsurg.2022.1050515. eCollection 2022.
Haemorrhoids are normal structures in the human body, only seen as pathological when symptomatic. Nowadays, new techniques have surfaced using a diode laser which, after locating the target arteries, blocks the blood flow while hitting and shrinking the local mucosa/submucosa at a depth of 4 mm. Our work aimed to give a broad view over this new technique and its consequences in the post-operative follow-up with a systematic review.
EMBASE and MEDLINE databases were consulted, retrieving clinical trials, which mentioned the use of 980 nm diode laser on the treatment of haemorrhoids.
Ten clinical trials analyzing the post-operative effects of laser haemorrhoidectomy were selected, including 2 randomized controlled clinical trials and 1 controlled clinical trial. The overall quality of the trials was low, indicating a high risk of bias.
The laser haemorrhoidectomy procedure revealed a high therapeutic potential, considering the reduced number of postoperative complaints (bleeding/pain), the high symptom resolution and the reduced recurrence, albeit the high heterogeneity between the studies in terms of reported results. Future investigations with higher quality and controlled double-blinded studies obtaining better-categorized results should be conducted in order to better evaluate this procedure and compare it to the current paradigm.
痔疮是人体的正常结构，只有出现症状时才被视为病理性的。如今，出现了使用二极管激光的新技术，该技术在定位目标动脉后，阻断血流，同时在4毫米深度处击中并收缩局部黏膜/黏膜下层。我们的工作旨在通过系统评价对这项新技术及其术后随访结果进行全面概述。
查阅了EMBASE和MEDLINE数据库，检索提及使用980纳米二极管激光治疗痔疮的临床试验。
选择了10项分析激光痔切除术术后效果的临床试验，包括2项随机对照临床试验和1项对照临床试验。试验的总体质量较低，表明存在较高的偏倚风险。
尽管各研究报告结果的异质性较高，但考虑到术后并发症（出血/疼痛）数量减少、症状缓解率高以及复发率降低，激光痔切除术显示出较高的治疗潜力。未来应开展更高质量的对照双盲研究，以获得更好分类的结果，从而更好地评估该手术并将其与当前的治疗模式进行比较。
