Abstract
BACKGROUND: Laser hemorrhoidectomy (LHP) is a minimally invasive procedure with less pain, short operative time and length of stay, and a low recurrent rate. This study aimed to analyze the surgical outcomes of the circumferential stapler hemorrhoidectomy (CSH, Longo operation) by propensity score-matching analysis, including perioperative outcomes and quality of life. MATERIALS AND METHODS: Between March 2022 and March 2023, 216 patients underwent CSH and 198 LHP in Binh Dan Hospital, Ho Chi Minh City, Vietnam. Potential confounding factors for operative outcomes were adjusted by propensity score-matching analysis. The gender, age, Goligher classification, symptoms, Hemorrhoidal Disease Symptom Score (HDSS), and the number of hemorrhoidal columns were matching variables. After 1:1 propensity score-matching, 115 patients from each group were evaluated for perioperative outcomes and compared for a prospective study. RESULTS: There was no difference in potential preoperative confounders such as gender, hemorrhoid classification, symptoms, and HDSS between the two groups after propensity score-matching. However, there was a difference in age (52 in the Longo group and 43 in the LHP group) and the number of columns (the LHP group had more). Postoperative outcomes such as operative time, blood loss, general complications, and postoperative interventions were less in the LHP group. However, Visual Analog Scale (VAS) (4 vs. 4), length of stay (1 day vs. 1 day), quality of life (both groups improved quality of life after the procedure), and recurrence rate (2 in the Longo group vs. 0 in the LHP group, p=0.5) had no difference between the two groups. CONCLUSIONS: Propensity-score matching analysis showed that the LHP procedure was superior to the Longo operation (CSH) in operative time, blood loss, general complications, and postoperative intervention. Other outcomes such as VAS, length of stay, quality of life, and recurrence rate have no difference.