Haemorrhoids or piles are the most common colorectal condition in the local population. Patients often present with bleeding with bowel movement or anal discomfort, both of which causes significant anxiety and stress. For symptomatic sizeable piles, the treatment of choice still remains the conventional open excision (COH). However, this technique carries with it a significant risk of bleeding and pain immediately after the operation, leading to some period of discomfort for the patients. The laser haemorrhoidoplasty procedure (LAH) has been shown in preliminary studies to have less pain, and less complications compared to COH. This study aims to directly compare these two techniques in a local Asian population. The investigators would be conducting a single-centre RCT simultaneously comparing the conventional open Milligan-Morgan haemorrhoidectomy (COH) and the laser haemorrhoidoplasty procedure (LAH) for the treatment of symptomatic grade ll-lV haemorrhoids. Primary outcomes will be post-operative pain while secondary outcomes include post-operative bleeding, readmission and/or reoperations, haemorrhoid-related quality of life (QoL) results and recurrence of symptoms up to a year post procedure
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
128
Using a laser diode to cause coagulative necrosis to the haemorrhoidal cushion
conventional excisional haemorrhoidectomy
Sengkang General Hospital
Singapore, Singapore
RECRUITINGPain scores
Daily visual analogue pain scale in the first 10 days after surgery. A score of 10 being the worst pain experienced and 1 being no pain experienced.
Time frame: 10 days from op
Operative duration
duration of operation
Time frame: during operation
Post-op bleeding
incidence of bleeding post op
Time frame: 10 days from operation
readmission
readmission due to complications
Time frame: 3 months
recurrence
recurrence of haemorrhoids or symptoms
Time frame: 1 year post operation
Quality of Life measures
2 validated questionnaires will be used (\[patient self reported symptoms of haemorrhoids\] Nystrom, et al. and \[standardised haemorrhoidectomy QOL survey\] Chew, et al)
Time frame: 10 days, 1 month, 3 months and 1 year post operation
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