Trial reportDiseases of the colon and rectum2026
Five-Year Follow-up of the Double-Blinded Randomized Controlled Trial Comparing Laser Hemorrhoidoplasty With Sutured Mucopexy and Excisional Hemorrhoidectomy.
Trial report in Diseases of the colon and rectum, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPatients randomly assigned to laser hemorrhoidoplasty, excisional hemorrhoidectomy, and sutured mucopexy were followed up at 5 years after surgery.
objectiveThe aim of this study was to compare the long-term results of laser hemorrhoidoplasty, excisional hemorrhoidectomy, and sutured mucopexy.
designA follow-up of randomized, parallel-group, double-blinded, single-center prospective study. SETTINGS: Treatment was provided between April 2016 and April 2017 at a single center. PATIENTS: Patients with symptomatic second- or third-degree hemorrhoids 5 years after surgery were interviewed via telephone or online questionnaire.
main outcome measuresRecurrence of symptoms was the primary outcome; patients' quality of life, fecal incontinence, and patients' evaluation of treatment were secondary outcomes.
resultsA total of 102 patients were evaluated at 5 years (34 per group). Kaplan-Meier estimates of 5-year symptom recurrence were 24% for excisional hemorrhoidectomy, 29% for laser hemorrhoidoplasty, and 44% for sutured mucopexy; these differences did not reach statistical significance (log-rank p = 0.076). Although recurrence-free probability was numerically higher in the excisional hemorrhoidectomy and laser hemorrhoidoplasty groups, the timing of events varied across cohorts. Specific recurrences included bleeding in 18% (excisional hemorrhoidectomy), 31% (sutured mucopexy), and 31% (laser hemorrhoidoplasty) and prolapse in 12% (excisional hemorrhoidectomy), 23% (laser hemorrhoidoplasty), and 34% (sutured mucopexy). General health evaluation scores were highest in the laser hemorrhoidoplasty group. A mixed-effect model for repeated measures analysis showed a continued trend of improvement in physical and social activity between 1 and 5 years across all groups ( p = 0.021). Decision regret was lowest in the sutured mucopexy group (mean score 1.33). LIMITATIONS: This is a single-center study with a relatively small sample size.
conclusionsPatients who underwent excisional hemorrhoidectomy reported the best outcomes; however, laser hemorrhoidoplasty produced only slightly worse results with a significantly shorter and less painful postoperative course. See Video Abstract . SEGUIMIENTO A CINCO AOS DEL ENSAYO CLNICO ALEATORIZADO DOBLE CIEGO QUE COMPARA LA HEMORROIDOPLASTIA LSER CON LA MUCOPEXIA SUTURADA Y LA HEMORROIDECTOMA POR ESCISIN: ANTECEDENTES:Se realizó un seguimiento a pacientes, asignados aleatoriamente a hemorroidoplastia láser, hemorroidectomía por escisión y mucopexia suturada, a los 5 años de la cirugía.OBJETIVO:El objetivo de este estudio fue comparar los resultados a largo plazo de la hemorroidoplastia láser, la hemorroidectomía por escisión y la mucopexia suturada.DISEÑO:Estudio prospectivo, unicéntrico, doble ciego, aleatorizado, de seguimiento y con grupos paralelos.ÁMBITO:Entre abril de 2016 y abril de 2017, se incluyeron 121 pacientes en el estudio.PACIENTES:Se entrevistó telefónicamente o mediante cuestionario en línea a pacientes con hemorroides sintomáticas de segundo o tercer grado, 5 años después de la cirugía.PRINCIPALES MEDIDAS DE RESULTADO:La recurrencia de los síntomas fue el resultado primario; la calidad de vida de los pacientes, la incontinencia fecal y la evaluación del tratamiento por parte de los pacientes fueron resultados secundarios.RESULTADOS:Se evaluó a un total de 102 pacientes a los 5 años (34 por grupo). Las estimaciones de Kaplan-Meier de la recurrencia de los síntomas a los 5 años fueron del 24% para la hemorroidectomía por escisión, del 29% para la hemorroidoplastia láser y del 44% para la mucopexia suturada; estas diferencias no alcanzaron significación estadística (log-rank p = 0,076). Si bien la probabilidad de ausencia de recurrencia fue numéricamente mayor en los grupos de hemorroidectomía por escisión y hemorroidoplastia láser, el momento de los eventos varió entre las cohortes. Las recurrencias específicas incluyeron sangrado en el 18% (hemorroidectomía por escisión), 31% (mucopexia suturada) y 31% (hemorroidectomía láser), y prolapso en el 12% (hemorroidectomía por escisión), 23% (hemorroidectomía láser) y 34% (mucopexia suturada). Las puntuaciones de evaluación de salud general fueron más altas en el grupo de hemorroidoplastia láser. El modelo de efectos mixtos para el análisis de medidas repetidas mostró una tendencia continua de mejora en la actividad física y social entre 1 y 5 años en todos los grupos (p = 0,021). El arrepentimiento por la decisión tomada fue menor en el grupo de mucopexia suturada (puntuación media de 1,33).LIMITACIONES:Este es un estudio unicéntrico, con un tamaño de muestra relativamente pequeño.CONCLUSIONES:Los pacientes sometidos a hemorroidectomía por escisión reportan los mejores resultados; sin embargo, la hemorroidoplastia láser produce resultados solo ligeramente peores, con un postoperatorio significativamente más corto y menos doloroso. (AI-generated translation ).
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