The New Technique in Hemorrhoid Disease: A Combination of Laser Hemorrhoidoplasty and Ferguson Hemorrhoidectomy

Abstract Purpose This study aimed to evaluate the early and long-term results of the three surgical methods (Ferguson hemorrhoidectomy, laser hemorrhoidoplasty, and combined method) of hemorrhoidal disease. Methods Between January 2018 and January 2020, 154 consecutive patients diagnosed with symptomatic grade II-III hemorrhoid disease were treated with Ferguson hemorrhoidectomy (FH group), laser hemorrhoidoplasty (LHP group), or combined (FH + LHP group) method. Patients were evaluated in terms of duration of surgery, recovery time of symptoms, postoperative pain, early and late complications, and recurrence. Results Postoperative pain scores on the 6th, 12th, 24th hours, and 7th day were significantly lower in the LHP group compared to other groups (p < 0.001). Upon development of postoperative perianal thrombosis in 2 patients of the LHP group, one patient underwent thrombectomy and the other patient underwent medical treatment. In the FH group, reoperation and hemostasis are done for bleeding on the postoperative 6th day in 1 patient, and a foley catheter was applied due to urinary retention in 1 patient. Two anal fissures were seen in postoperative one month in the FH group and recovered with medical treatment and sitz bath. There were two hemorrhoid disease recurrences the median follow-up period of 24 (12–36) months in the LHP group only. Conclusion In patients with multiple hemorrhoid packages with both grade 2 and also grade 3 disease, the combined method can be better used safely and effectively, despite relatively higher pain scores, and prolonged operation time compared to the LHP method but considering rare complications and recurrences.