Predictive Factors for Recurrence Following Hemorrhoidectomy Using the LEONARDO Laser Technique
DOI:
https://doi.org/10.35516/jmj.v59i2.2624Keywords:
defecation habit, hemorrhoids, LEONARDO technique, obstructive defecation syndromeAbstract
Purpose: This study investigates the influence of various factors, including defecation habits, age, gender, and obesity, on the recurrence of hemorrhoids after treatment with the LEONARDO laser technique. Hemorrhoids, a prevalent anorectal condition, often require intervention ranging from conservative management to surgical procedures. Traditional hemorrhoidectomy is associated with postoperative pain and high recurrence rates, whereas the LEONARDO laser technique promises a safer and less invasive alternative.
Methods: A comprehensive analysis was conducted on patients who underwent hemorrhoidectomy using the LEONARDO laser technique. The study focused on assessing the impact of several risk factors, such as defecation habits (with a particular emphasis on obstructive defecation syndrome), age, gender, and obesity, on the recurrence of hemorrhoids. Data were collected over a two-year follow-up period post-surgery.
Results: The findings revealed a significant correlation between certain defecation habits, notably obstructive defecation syndrome, and an increased rate of hemorrhoid recurrence, especially in older female patients. The study also observed that other factors like age, gender, and obesity played a role in the recurrence rates, although the impact of defecation habits was more pronounced.
Conclusions: The results of this study highlight the critical importance of considering individual defecation patterns, particularly obstructive defecation syndrome, in the management and prognosis of hemorrhoids post-LEONARDO laser treatment. These insights can guide clinicians in tailoring postoperative care and counseling to reduce recurrence rates and improve patient outcomes.
References
Guttadauro A, Maternini M, Chiarelli M, Lo Bianco G, Pecora N, Gabrielli F. Evolution in the surgical management of hemorrhoidal disease. Ann Ital Chir. 2018;89:101-106.
Schubert MC, Sridhar S, Schade RR, Wexner SD. What every gastroenterologist needs to know about common anorectal disorders. World J Gastroenterol. 2009 Jul 14;15(26):3201-9.
Cohen-Mansfield J., Shmotkin D., Blumstein Z. The old, old-old, and the oldest old: continuation or distinct categories? An examination of the relationship between age and changes in health, function, and well-being. Int. J. Aging Hum. Dev. 2013;77(1):37–57.
Rakinic J. Benign Anorectal Surgery: Management. Adv Surg. 2018 Sep;52(1):179-204.
Mott T, Latimer K, Edwards C. Hemorrhoids: Diagnosis and Treatment Options. Am Fam Physician. 2018 Feb 01;97(3):172-179.
Gravina AG, Pellegrino R, Facchiano A, Palladino G, Loguercio C, Federico A. Evaluation of the efficacy and safety of a compound of micronized flavonoids in combination with vitamin C and extracts of centella asiatica, vaccinium myrtillus, and vitis vinifera for the reduction of hemorrhoidal symptoms in patients with grade II and III hemorrhoidal disease: a retrospective real-life study. Front Pharmacol. (2021) 12:773320.
Diop B, Ba PA, Diouf A, NDiaye B, Phiri A, Sylla C. Treatment of Haemorrhoidal Disease by Laser Haemorrhoidoplasty at Dakar Preliminary Study of 21 Patients. J West Afr Coll Surg. 2021 Oct-Dec;11(4):33-37.
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. Int J Colorectal Dis. 2020;35:481–90.
Angioni S, Pontis A, Sorrentino F, Nappi L. Bilateral salpingo-oophorectomy and adhesiolysis with single port access laparoscopy and use of diode laser in a BRCA carrier. Eur J Gynaecol Oncol. 2015;36(4):479-81.
Rao SS. Pathophysiology of adult fecal incontinence. Gastroenterology. 2004;126:S14–22.
Scott SM, Gladman MA. Manometric, sensorimotor, and neurophysiologic evaluation of anorectal function. Gastroenterol Clin North Am. 2008;37:511–38.)
Taft TH, Kern E, Keefer L, Burstein D, Hirano I. Qualitative assessment of patient-reported outcomes in adults with eosinophilic esophagitis. J Clin Gastroenterol. 2011;45:769–774.
Guttadauro A, Maternini M, Chiarelli M, Lo Bianco G, Pecora N, Gabrielli F. Evolution in the surgical management of hemorrhoidal disease. Ann Ital Chir. 2018;89:101-106.
Lorenzo-Rivero S. Hemorrhoids: diagnosis and current management. Am Surg. 2009 Aug;75(8):635-42
Mott T, Latimer K, Edwards C. Hemorrhoids: Diagnosis and Treatment Options. Am Fam Physician. 2018 Feb 01;97(3):172-179
Lohsiriwat V, Sheikh P, Bandolon R, Ren DL, Roslani AC, Schaible K,et al. Recurrence Rates and Pharmacological Treatment for Hemorrhoidal Disease: A Systematic Review. Adv Ther. 2023 Jan;40(1):117-132.
Godeberge P, Sheikh P, Zagriadskii E. Hemorrhoidal disease and chronic venousinsufficiency: concomitance or coincidence; results of the CHORUS study (Chronic venous and HemORrhoidal diseases evaluation and Scientific research) J Gastroenterol Hepatol. 2020;35(4): 577–585
Yamamoto M, Ikeda M, Matsumoto T, Takemoto M, Sumimoto R, Kobayashi T et al. Hemorrhoidectomy for elderly patients aged 75 years or more, before and after studies. Ann Med Surg (Lond). 2020 May 16;55:88-92.
Picciariello A, O’Connell PR, Hahnloser D, Gallo G, Munoz-Duyos A, Schwandner O, et al. Obstructed defaecation syndrome: European consensus guidelines on the surgical management. Br J Surg. (2021) 108(10):1149–53.
heng T, Ellinghaus D, Juzenas S, Cossais F, Burmeister G, Mayr G, et al. Genome-wide analysis of 944 133 individuals provides insights into the etiology of haemorrhoidal disease. Gut. (2021) 70(8):1538–49.
Nagaraj SV, Mori A, Reddy M. Association of Hemorrhoid Vascular Injuries with Cigarette Smoking-An Evaluation with Interesting Prospects. Surg J (N Y). 2019 Nov 7;5(4):e172-e176.
Lee JH, Kim HE, Kang JH, Shin JY, Song YM. Factors associated with hemorrhoids in Korean adults: korean national health and Nutrition examination survey. Korean J. Family Med. 2014; 35(5):227–236.
Wani AA, Khuroo S, Heer VK, Jain SK, Rajput D, Maqsood S, et al. Recurrent Hemorrhoids-Efficacy, Utility and Initial Experience with the Use of Stapled Hemorrhoidopexy in Recurrent Hemorrhoids. J Coloproctol (Rio J). 2021Jul;41(3):281–5
