Complications Associated With Coloproctological Surgeries Using a 1940 nm Wavelength Laser

Aim: to analyze complications arising from coloproctological surgeries using a 1940 nm wavelength laser, identify their causes, and propose preventive measures.

Materials and methods. 148 patients with stage 2–3 hemorrhoids underwent transdermal laser submucosal destruction of internal hemorrhoids using a diode-pumped fiber laser with a wavelength of 1940 nm and a power of 7.5 W in a pulsed-periodic mode (pulse — 500 ms, pause — 750 ms).

Results. Intraoperatively, bleeding from the internal hemorrhoid developed in 4.4 % (3/148) of patients. The cause was its trauma with a laser instrument and a violation of the integrity of the mucous membrane of the internal hemorrhoid. In this regard, hemorrhoidectomy was performed. The occurrence of intraoperative hematoma was diagnosed in 10.1 % (15/148) of patients and regarded as a complication. In all cases, the submucous hematoma was characterized by small sizes (3.0–4.0 cm) and did not increase during observation for 5–10 minutes. In the early postoperative period (on the first day after surgery), thrombosis of external hemorrhoids developed in 5.4 % (8/148) of patients, which regressed completely with conservative treatment. In the early postoperative period, 0.7 % (1/148) of patients were diagnosed with the development of an ulcerative mucosal defect in the area of the internal hemorrhoid, which healed with conservative therapy. According to our analysis, the main causes of complications are incorrect surgical technique and excessive laser energy exposure.

Conclusion. Laser methods are promising for minimally invasive treatment of anorectal diseases but require strict adherence to surgical techniques and control of energy parameters. Optimizing methodology and standardizing approaches will help reduce the frequency of complications and improve treatment safety.

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