- 期刊
Efficacy and Safety of Laser Hemorrhoidoplasty in High-risk Patients: A Case-matched Study in a Single Center
雷射痔瘤整形術運用於高風險病患之安全性以及效果：單一中心病例對照研究
摘要
Introduction. Hemorrhoids significantly impact one's quality of life, often necessitating surgical intervention. Laser hemorrhoidoplasty (LHP) has emerged as a relatively new minimally invasive option. However, the safety and efficacy were still not evaluated in high-risk patients. Methods. A retrospective analysis was conducted at Taichung Veterans General Hospital, encompassing patients with symptomatic grade II-III hemorrhoids who underwent LHP between September 2020 and August 2022. Patients were categorized into high-risk (ASA score 3-4) and low-risk (ASA score 1-2) groups. Propensity score matching was employed to ensure balanced demographic and clinical characteristics between the groups. Data on patient demographics, surgical technique, postoperative outcomes, and follow-up were all collected and analyzed. Results. Of the 182 patients who underwent LHP during the study period, 10 were categorized as high-risk, with 20 propensity-matched low-risk patients selected. The two groups exhibited similar baseline characteristics. No significant differences were observed in pain levels, complication rates, or patient satisfaction between the high-risk and low-risk groups. LHP demonstrated favorable short-term outcomes, including both reduced postoperative pain and bleeding. During telephone follow-ups, symptom recurrence rates were comparable between the two groups. However, a few patients reported dissatisfaction, primarily due to postoperative discomfort. Conclusion. Laser hemorrhoidoplasty appears to be a safe and effective treatment for high-risk patients diagnosed with symptomatic hemorrhoids. Its minimally invasive nature and favorable short-term outcomes support its use as an alternative to traditional surgical interventions. Further research with extended follow-up is still needed in order to validate these findings.
並列摘要
雷射痔瘤整形術為一新的微創手術選擇，且適用於高風險患者。本研究評估了LHP在這群病患中的安全性和有效性。在台中榮民總醫院進行了一項回顧性分析，自2020年9月至20229年8月期間接受治療的患者。患者被分為高風險（ASA分數3-4）和低風險（ASA分數1-2）兩組。採用傾向性分數匹配並收集和分析了患者的人口統計學資料、手術技術、術後結果和隨訪資料。研究共包含10名高風險以及配對的20名低風險病患，兩組之間的術後疼痛、併發症、滿意度以及復發率皆無顯著差異。此術式是一種安全有效的治療方法，且適用於高風險患者。但仍然需要更大量之樣本數、進一步的研究以及長期追蹤以驗證此結果。