A COMPARATIVE STUDY BETWEEN LASER HAEMORRHOIDOPLASTY AND OPEN HAEMORRHOIDECTOMY DONE FOR HAEMORRHOIDS IN A RURAL MEDICAL COLLEGE

Background: Hemorrhoidal disease is a common anorectal condition affecting a significant proportion of the adult population. While open hemorrhoidectomy remains the standard surgical treatment for symptomatic hemorrhoids, minimally invasive techniques such as laser hemorrhoidoplasty are gaining popularity due to perceived advantages in postoperative recovery. In rural healthcare settings, choosing the optimal surgical modality is crucial given limited resources and varied patient profiles. Aim: To compare laser hemorrhoidoplasty with open hemorrhoidectomy in terms of operative time, postoperative pain, recovery, and complication rates among patients with symptomatic grade 1–3 hemorrhoids in a rural medical college setting. Methods: This prospective observational comparative study was conducted at S.B.K.S. Medical Institute and Research Centre, Gujarat, India, involving 50 patients aged 18–60 years with symptomatic grade 1–3 hemorrhoids. Patients were randomly assigned to two groups: laser hemorrhoidoplasty (n=25) and open hemorrhoidectomy (n=25). Operative time, postoperative pain (VAS/VDS), healing time, blood loss, and complications such as hemorrhage, fissure/ulcer, urinary retention, recurrence, and satisfaction were recorded and analyzed. Patients were followed up at 12h, 24h, 48h, 7 days, 1 month, and 3 months. Statistical analysis included t-tests, Mann-Whitney U, and chi-square tests with a significance level of p<0.05. Results: Mean operative time was comparable between laser (56.84 mins) and open (58.44 mins) procedures (p=0.766). Pain levels showed no significant difference; mild and severe pain were reported in both groups with similar frequency. Postoperative complications varied slightly: delayed hemorrhage (16% vs. 4%), fissure/ulcer (16% vs. 4%), and anal incontinence (20% vs. 8%) were higher in the laser group, whereas recurrence was more frequent in the open group (32% vs. 16%). Mean blood loss was nearly identical across both groups (~122 ml). Patient satisfaction at 3 months was marginally higher in the open surgery group (80% vs. 68%). Hospital stay was generally 2–5 days for both groups. Conclusion: Laser hemorrhoidoplasty and open hemorrhoidectomy are comparable in operative time, pain control, blood loss, and overall safety. While laser surgery showed slightly higher minor complication rates, it also resulted in fewer recurrences. Both procedures can be effectively used in rural outpatient settings, and choice should be tailored based on patient condition, surgeon expertise, and resource availability.