Evaluation of the Effect of Laser Radiation on Microcirculation Parameters in Patients with the Stage III Chronic Hemorrhoids
https://doi.org/10.52420/umj.24.6.43
EDN: YDYXDW
Abstract
Introduction. Hemorrhoids are accompanied by impaired microcirculation. Modern treatment methods require an assessment of the microvasculature.
Purpose is to evaluate the efficacy and determine the optimal parameters of laser destruction in patients with stage III hemorrhoids based on microcirculation indicators.
Materials and methods. The study included 80 patients: the main group was divided into 3 subgroups of 20 persons each with stage III hemorrhoids, and 20 healthy volunteers (control group). The main group was divided depending on the power of laser destruction. Microcirculation was assessed by laser Doppler flowmetry.
Results. The use of laser Doppler flowmetry showed the best results at a power of 8 W.
Discussion. The use of laser radiation at a power of 8 W provides faster recovery of microcirculation.
Conclusion. Laser destruction of hemorrhoids contributes to the restoration of microcirculation, with the best results achieved at a power of 8 W.
About the Authors
A. A. ZasorinRussian Federation
Alexander A. Zasorin – Doctor of Sciences (Medicine), Associate Professor of the Department of Surgical
Diseases, Institute of Surgery
Ekaterinburg
Competing Interests:
The authors declare the absence of obvious or potential conflict of interest.
D. M. Sozonov
Russian Federation
Dmitry M. Sozonov – Surgeon
Ekaterinburg
Competing Interests:
The authors declare the absence of obvious or potential conflict of interest.
References
1. Lohsiriwat V. Hemorrhoids: From basic pathophysiology to clinical management. World Journal of Gastroenterology. 2012;18(17):2009–2017. DOI: https://doi.org/10.3748/wjg.v18.i17.2009.
2. Zagriadskiĭ EA, Bogomazov AM, Golovko EB. Conservative treatment of hemorrhoids: Results of an observational multicenter study. Advances in Therapy. 2018;35(12):1979–992. DOI: https://doi.org/10.1007/s12325-018-0794‑x.
3. Rodoman GV, Kornev LV, Shalaeva TI, Malushenko RN. Efficiency of combined methods of hemorroid treatment using HAL-RAR and laser destruction. Pirogov Russian Journal of Surgery. 2017;(5):47–51. (In Russ.). DOI: https://doi.org/10.17116/hirurgia2017547-51.
4. Acheson AG, Scholefield JH. Management of haemorrhoids. BMJ. 2008;336(7640):380–383. DOI: https://doi.org/10.1136/bmj.39465.674745.80.
5. He YH, Tang ZJ, Xu XT, Huang DQ, Zhang LS, Tang QZ, et al. A randomized multicenter clinical trial of RPH with the simplified milligan-morgan hemorrhoidectomy in the treatment of mixed hemorrhoids. Surgical Innovation. 2017;24(6):574–581. DOI: https://doi.org/10.1177/1553350617731205.
6. Titov AYu, Kostevich IV. Submucosal laser ablation of internal hemorrhoids. Pirogov Russian Journal of Surgery. 2020;(3):89–96. (In Russ.). DOI: https://doi.org/10.17116/hirurgia202003189.
7. Vasiliev SV, Nedozimovanyy AI, Popov DE, Sorkin RG, Gor IV. Laser submucosal destruction of chronic hemorrhoids stage II–III. Koloproktologiia. 2019;18(2):21–26. DOI: https://doi. org/10.33878/2073-7556-2019-18-2-21-26.
8. Ram E, Kayzer M, Zager Y, Anteby R, Nachmany I, Carter D, et al. Laser hemorrhoidoplasty for II–IV grade hemorrhoids: Should we treat them the same? Updates in Surgery. 2023;75(3): 635–642. DOI: https://doi.org/10.1007/s13304-023-01480-0.
9. Rubbini M, Ascanelli S. Classification and guidelines of hemorrhoidal disease: Present and future. World Journal of Gastrointestinal Surgery. 2019;11(3):117–121. DOI: https://doi.org/10.4240/wjgs.v11.i3.117.
10. Gravié JF, Lehur PA, Huten N, Papillon M, Fantoli M, Descottes B, et al. Stapled hemorrhoidopexy versus Milligan-Morgan hemorrhoidectomy: A prospective, randomized, multicenter trial with 2‑year postoperative follow up. Annals of Surgery. 2005;242(1):29–35. DOI: https://doi.org/10.1097/01.sla.0000169570.64579.31.
11. Poskus T, Danys D, Makunaite G, Mainelis A, Mikalauskas S, Poskus E, et al. Results of the double‑blind randomized controlled trial comparing laser hemorrhoidoplasty with sutured mucopexy and excisional hemorrhoidectomy. International Journal of Colorectal Disease. 2020;35(3):481–490. DOI: https://doi.org/10.1007/s00384-019-03460-6.
12. Plapler H, Hage R, Duarte J, Lopes N, Masson I, Cazarini C, et al. A new method for hemorrhoid surgery: Intrahemorrhoidal diode laser. Photomedicine and Laser Surgery. 2009:27(5):819–823. DOI: https://doi.org/10.1089/pho.2008.2368.
13. Salgueiro P, Ramos MI, Castro-Poças F, Libânio D. Office-based procedures in the management of hemorrhoidal disease: Rubber band ligation versus sclerotherapy — systematic review and meta-analysis. GE — Portuguese Journal of Gastroenterology. 2022;29(6):409–419. DOI: https://doi.org/10.1159/000522171.
14. Avital S, Inbar R, Karin E, Greenberg R. Five-year follow-up of Doppler-guided hemorrhoidal artery ligation. Techniques in Coloproctology. 2012;16(1):61–65. DOI: https://doi.org/10.1007/s10151-011-0801-6.
15. Jahanshahi A, Mashhadizadeh E, Sarmast MH. Diode laser for treatment of symptomatic hemorrhoid: A short term clinical result of a mini invasive treatment, and one year follow up. Polish Journal of Surgery. 2012;84(7):329–332. Available from: https://clck.ru/3QAynz (accessed 17 July 2025).
16. Hodgson WJ, Morgan J. Ambulatory hemorrhoidectomy with CO2 laser. Diseases of the Colon & Rectum. 1995;38(12):1265–1269. DOI: https://doi.org/10.1007/BF02049150.
17. Symeonidis D, Spyridakis M, Zacharoulis D, Tzovaras G, Samara AA, Valaroutsos A, et al. Milligan-Morgan hemorrhoidectomy vs. hemorrhoid artery ligation and recto-anal repair: A comparative study. BMC Surgery. 2022;22(1):416. DOI: https://doi.org/10.1186/s12893-022-01861‑z.
18. Gambardella C, Brusciano L, Brillantino A, Parisi S, Lucido FS, Del Genio G, et al. Mid‑term efficacy and postoperative wound management of laser hemorrhoidoplasty vs conventional excisional hemorrhoidectomy in grade III hemorrhoidal disease: The twisting trend. Langenbeck’s Archives of Surgery. 2023;408(1):140. DOI: https://doi.org/10.1007/s00423-023-02879-4.
19. Jin L, Qin K, Wu R, Yang H, Cui C, Wang Z, et al. Laser hemorrhoidoplasty vs. rubber band ligation: A randomized trial comparing 2 mini-invasive treatment for grade II hemorrhoids. BMC Surgery. 2024;24(1):164. DOI: https://doi.org/10.1186/s12893-024-02425‑z.
20. Maloku H, Gashi Z, Lazovic R, Islami H, Juniku-Shkololli A. Laser hemorrhoidoplasty procedure vs open surgical hemorrhoidectomy: A trial comparing 2 treatments for hemorrhoids of third and fourth degree. Acta Informatica Medica. 2014;22(6):365–367. DOI: https://doi.org/10.5455/aim.2014.22.365-367.
21. Cherepenin MYu, Gorskiy VA, Armashov VP. Results of hemorrhoid treatment by destruction of hemorrhoidal nodes using a diode laser. Koloproktologiia. 2020;19(2):104–111. DOI: https://doi.org/10.33878/2073-7556-2020-19-2-104-111.
22. Plapler H, Hage R, Duarte J, Lopes N, Masson I, Cazarini C, et al. A new method for hemorrhoid surgery: Intrahemorrhoidal diode laser, does it work? Photomedicine and Laser Surgery. 2009; 27(5):819–823. DOI: https://doi.org/10.1089/pho.2008.2368.
23. Wilkerson PM, Strbac M, Reece-Smith H, Middleton SB. Doppler-guided haemorrhoidal artery ligation: Long-term outcome and patient satisfaction. Colorectal Disease. 2009;11(4):394–400. DOI: https://doi.org/10.1111/j.1463-1318.2008.01602.x.
24. Lie H, Caesarini EF, Purnama AA, Irawan A, Sudirman T, Jeo WS, et al. Laser hemorrhoidoplasty for hemorrhoidal disease: A systematic review and meta‑analysis. Lasers in Medical Science. 2022;37(9):3621–3630. DOI: https://doi.org/10.1007/s10103-022-03643-8.
25. Trigui A, Rejab H, Akrout A, Trabelsi J, Zouari A, Majdoub Y, et al. Laser utility in the treatment of hemorrhoidal pathology: A review of literature. Lasers in Medical Science. 2022;37(2):693–699. DOI: https://link.springer.com/article/10.1007/s10103-021-03333‑x.
Review
For citations:
Zasorin AA, Sozonov DM. Evaluation of the Effect of Laser Radiation on Microcirculation Parameters in Patients with the Stage III Chronic Hemorrhoids. Ural Medical Journal. 2025;24(6):43–52. (In Russ.) https://doi.org/10.52420/umj.24.6.43. EDN: YDYXDW












