Comparison between laser hemorrhoidoplasty procedure and conventional open surgical hemorrhoidectomy

Background: Hemorrhoids are a very common anorectal condition defined as the symptomatic enlargement and distal displacement of the normal anal cushions.Objective: The present study aimed to compare between laser hemorrhoidoplasty and conventional open surgical hemorrhoidectomy in treatment of the hemorrhoidal diseases.Patients and methods: This study included 30 patients with symptomatizing hemorrhoidal diseases. They were divided into two groups: 15 patients underwent open method (MMH) and 15 patients underwent laser method (LHP). They were admitted to General Surgery Department, Faculty of Medicine, Zagazig University Hospitals with symptomatic hemorrhoidal diseases. Full history, clinical examination and pre- and post-operative assessment were performed.Results: The mean age was distributed as 36.03 ± 7.32 in the MMH group and 35.73 ± 8.39 years in the LHP group with no significant difference between both groups. The mean operative time was distributed as 29.53 ± 4.05 and 14.60 ± 3.13 minutes for MMH and LHP groups respectively. The mean hospital stay for MMH group was 36.25 ± 6.58 hours and 7.85 ± 2.11 hours for LHP, MMH group significantly associated with longer hospital stay. MMH group was significantly associated with more bleeding at 1st and 2nd week but no bleeding founded after 2nd week at both groups.Conclusion: laser hemorrhoidoplasty (LHP) technique for the management of hemorrhoids was, with shorter operative time, less postoperative pain, shorter hospital stay, and less postoperative complications than open surgical hemorrhoidectomy

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population