Annals of Coloproctology

Display

Sort by :

Original Article

Anorectal benign disease

Cryotherapy reduces pain post-hemorrhoidectomy (CYPHER): a randomized, controlled, superiority trial of intra-anal ice after surgery for grade III hemorrhoids: Isaac Seow-En, Lionel Raphael Hui Chen, Yun Zhao, Yvonne Ying-Ru Ng, Emile Kwong-Wei Tan; Ann Coloproctol. 2025;41(6):537-544. Published online December 24, 2025; DOI: https://doi.org/10.3393/ac.2025.00549.0078

2,491 View
83 Download

Abstract PDF Supplementary Material: Purpose
We aimed to determine whether intra-anal cryotherapy reduces postoperative pain in patients undergoing hemorrhoidectomy.
Methods
This randomized controlled trial was conducted from January 2023 to August 2024. Patients with symptomatic grade III hemorrhoids were randomized 1:1 to receive either 1 minute of intra-anal cryotherapy or standard postoperative care. Because cryotherapy was applied before reversal of general anesthesia, patients were blinded to treatment allocation. The primary outcome was pain at rest on postoperative day (POD) 1. Secondary outcomes included pain after defecation, time to return to work or non-work activities, 30-day complications, and compliance with analgesia. Pain was measured using the visual analog scale.
Results
A total of 50 patients were randomized (25 per group). All 50 were included in the analysis. Baseline clinicodemographic characteristics were comparable between groups. The primary outcome, POD 1 pain at rest, did not demonstrate superiority of cryotherapy compared with standard care (median 3.0 vs. 4.0, P=0.062). However, the POD 1 pain score after defecation was significantly lower with cryotherapy than without (3.0 vs. 4.0, P=0.046). On POD 2, median pain scores at rest and after defecation were both significantly lower in the cryotherapy cohort (at rest: 2.0 vs. 4.0, P=0.043; after defecation: 2.0 vs. 5.0, P=0.001).
Conclusion
Intra-anal cryotherapy significantly reduces pain after defecation in the early postoperative period following surgery for grade III hemorrhoids. Its therapeutic efficacy, ease of application, and safety support consideration for routine use. Trial registration ClinicalTrials.gov identifier: NCT06005727

Reviews

ERAS

Venous thromboembolism among Asian populations with localized colorectal cancer undergoing curative resection: is pharmacological thromboprophylaxis required? A systematic review and meta-analysis: Shih Jia Janice Tan, Emile Kwong-Wei Tan, Yvonne Ying Ru Ng, Rehena Sultana, John Carson Allen, Isaac Seow-En, Ronnie Mathew, Aik Yong Chok; Ann Coloproctol. 2024;40(3):200-209. Published online May 16, 2024; DOI: https://doi.org/10.3393/ac.2022.01046.0149

5,860 View
202 Download
2 Web of Science
2 Citations

Abstract PDF

Purpose
We compared the incidence of venous thromboembolism (VTE) among Asian populations with localized colorectal cancer undergoing curative resection with and without the use of pharmacological thromboprophylaxis (PTP).
Methods
A comprehensive literature search was undertaken to identify relevant studies published from January 1, 1980 to February 28, 2022. The inclusion criteria were patients who underwent primary tumor resection for localized nonmetastatic colorectal cancer; an Asian population or studies conducted in an Asian country; randomized controlled trials, case-control studies, or cohort studies; and the incidence of symptomatic VTE, deep vein thrombosis, and/or pulmonary embolism as the primary study outcomes. Data were pooled using a random-effects model. This study was registered in PROSPERO on October 11, 2020 (No. CRD42020206793).
Results
Seven studies (2 randomized controlled trials and 5 observational cohort studies) were included, encompassing 5,302 patients. The overall incidence of VTE was 1.4%. The use of PTP did not significantly reduce overall VTE incidence: 1.1% (95% confidence interval [CI], 0%–3.1%) versus 1.9% (95% CI, 0.3%–4.4%; P = 0.55). Similarly, PTP was not associated with significantly lower rates of symptomatic VTE, proximal deep vein thrombosis, or pulmonary embolism.
Conclusion
The benefit of PTP in reducing VTE incidence among Asian patients undergoing curative resection for localized colorectal cancer has not been clearly established. The decision to administer PTP should be evaluated on a case-bycase basis and with consideration of associated bleeding risks.

Citations

Citations to this article as recorded by

Effectiveness and Safety of Long-Term Venous Thromboembolism Prophylaxis After Colorectal Cancer Surgery: A Retrospective Study
Ying Zhang, Xiaozhu Zhou, Yi Wu, Shicai Chen, Xiangli Cui, Ying Zhao
Drugs - Real World Outcomes.2025; 12(3): 479. CrossRef
Machine learning-based risk prediction of postoperative deep vein thrombosis in Chinese patients undergoing gastrointestinal surgery
Likui Huang, Lihua Gong, Jun Chen, Xiaojing Chen, Bicha Yao, Zhengrong Wang, Shuwei Weng
Frontiers in Cardiovascular Medicine.2025;[Epub] CrossRef

Laser hemorrhoidoplasty versus conventional hemorrhoidectomy for grade II/III hemorrhoids: a systematic review and meta-analysis: Ian Jun Yan Wee, Chee Hoe Koo, Isaac Seow-En, Yvonne Ying Ru Ng, Wenjie Lin, Emile John Kwong-Wei Tan; Ann Coloproctol. 2023;39(1):3-10. Published online January 3, 2023; DOI: https://doi.org/10.3393/ac.2022.00598.0085

19,061 View
526 Download
28 Web of Science
36 Citations

Abstract PDF Supplementary Material

Purpose
This study compared the short- and long-term clinical outcomes of laser hemorrhoidoplasty (LH) vs. conventional hemorrhoidectomy (CH) in patients with grade II/III hemorrhoids.
Methods
PubMed/Medline and the Cochrane Library were searched for randomized and nonrandomized studies comparing LH against CH in grade II/III hemorrhoids. The primary outcomes included postoperative use of analgesia, postoperative morbidity (bleeding, urinary retention, pain, thrombosis), and time of return to work/daily activities.
Results
Nine studies totaling 661 patients (LH, 336 and CH, 325) were included. The LH group had shorter operative time (P<0.001) and less intraoperative blood loss (P<0.001). Postoperative pain was lower in the LH group, with lower postoperative day 1 (mean difference [MD], –2.09; 95% confidence interval [CI], –3.44 to –0.75; P=0.002) and postoperative day 7 (MD, –3.94; 95% CI, –6.36 to –1.52; P=0.001) visual analogue scores and use of analgesia (risk ratio [RR], 0.59; 95% CI, 0.42–0.81; P=0.001). The risk of postoperative bleeding was also lower in the LH group (RR, 0.18; 95% CI, 0.12– 0.28; P<0.001), with a quicker return to work or daily activities (P=0.002). The 12-month risks of bleeding (P>0.999) and prolapse (P=0.240), and the likelihood of complete resolution at 12 months, were similar (P=0.240).
Conclusion
LH offers more favorable short-term clinical outcomes than CH, with reduced morbidity and pain and earlier return to work or daily activities. Medium-term symptom recurrence at 12 months was similar. Our results should be verified in future well-designed trials with larger samples.

Citations

Citations to this article as recorded by

Effect of Doppler-guided Hemorrhoidal Artery Ligation Technique and Mucopexy on Posttreatment Symptoms in Hemorrhoidal Disease
İbrahim Öner, Sami Benli̇, Cumhur Özcan, Muhanned Alkhatib, Erkan Güler, Elif Ertaş, Tahsin Çolak
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2026;[Epub] CrossRef
Laser Hemorrhoidoplasty for Grade III Hemorrhoidal Disease: Safety and Efficacy in a Brazilian Multicenter Retrospective Cohort Study
Fabrício Doin Paz de Oliveira, Bruno Lorenzo Scolaro, Ana Carolina Buffara Blitzkow, Sonia Cristina Cordero Time, Alline Maciel Pinheiro Borges, Thais Alencar Pinto dos Santos, Alfadl Abdulfattah, Elisa Treptow Marques Lemos, Glicia Estevam de Abreu
Photobiomodulation, Photomedicine, and Laser Surgery.2026;[Epub] CrossRef
In-silico engineering of an antimicrobial growth factor fusion protein to prevent post-laser infection in hemorrhoidal wounds
Özlem Karaca Ocak, Zoha Naeem
Medical Journal of Western Black Sea.2026; 10(1): 9. CrossRef
RISKS OF COMPLICATIONS AND STATISTICAL CRITERION OF “ODDS RATIO” (OR) AS INDICATORS OF THE EFFECTIVENESS OF LASER VAPORIZATION OF HEMORRHOIDAL VESSELS
K Satanova, A Fursov, R Fursov, A Kaipova, A Talassov
BULLETIN OF SURGERY OF KAZAKHSTAN.2026; 22(1): 58. CrossRef
Determinants influencing decision-making for operative and perioperative management of grade III and IV hemorrhoidal disease: secondary analysis of a multicenter nationwide prospective cohort study
Metin Kement, Orhan Ali̇moğlu, Hakan Baysal, Salih Tosun, Atif Tekin, Ilker Sucullu, Osman Ci̇vi̇l, Nevi̇n Sakoğlu, Naci̇ye Çi̇ğdem Arslan, Ci̇had Tatar, Rozan Kaya, Ali̇ Emre Nayci, Taygun Gülşen, Serhat Meri̇c, Farid Mohamad Hamad, Ahmed Salhat, Ni̇hat
Langenbeck's Archives of Surgery.2026;[Epub] CrossRef
Evaluation of short-term outcomes of Endoscopic Super-Hemorrhoidal Banding for mixed hemorrhoids with prolapsed internal hemorrhoids: a retrospective study
Xiujiang Huang, Wen Xu, Hao Lin, Ping Jiang, Hongjing Yang, Lijuan Chen, Kaixi Yang, Yuji Huang, Ying Zhu, Jun Liu
BMC Surgery.2026;[Epub] CrossRef
Laserbehandlung beim Hämorrhoidalleiden
Peter C. Ambe
coloproctology.2026;[Epub] CrossRef
Laser hemorrhoidoplasty versus hemorrhoidectomy in the treatment of surgically indicated hemorrhoids in inflammatory bowel patients: a randomized comparative clinical study
Reham Zakaria, Mohamed Mahmoud Amin, Heba Alhussein Abo-Alella, Yasmine Hany Hegab
Surgical Endoscopy.2025; 39(1): 249. CrossRef
Best clinical practice recommendations for the management of symptomatic hemorrhoids via laser hemorrhoidoplasty: the LHP recommendations
P. C. Ambe, G. P. Martin-Martin, N. Vasas, I. Piponski, I. H. Roman, J. D. P. Hernandez, H. Ma, H.C. Lin, G. Weyand, L. Mazlan, L. J. García Flórez, K. Wolff, M. Dessily, C. Wang, V. Dobricanin, W. Yang, T. Bruketa, X.D. Zeng, S. Avdicausevic, Z.G. Zhang,
Techniques in Coloproctology.2025;[Epub] CrossRef
Which Technique is Preferable for Grade 2–3 Hemorrhoidal Disease: Laser vs. Rubber Band Ligation? A Retrospective Study
Ahmet Cihangir Emral, Merter Gülen, Bahadır Ege
Bratislava Medical Journal.2025; 126(1): 91. CrossRef
Precision cuts time-comparative outcomes of laser hemorrhoidoplasty and open hemorrhoidectomy
Shreya, Prajwal Chandrashekar
International Surgery Journal.2025; 12(5): 743. CrossRef
Latest Research Trends on the Management of Hemorrhoids
Sung Il Kang
Journal of the Anus, Rectum and Colon.2025; 9(2): 179. CrossRef
Hämorrhoidalleiden und stadienabhängige Behandlung (inklusive Analprolaps)
Oliver Schwandner
Die Chirurgie.2025; 96(9): 709. CrossRef
Laser Hemorrhoidoplasty: Procedure, Outcomes and Future Directions
Michele di Schiano di Visconte
ANZ Journal of Surgery.2025; 95(11): 2301. CrossRef
Comparison of efficacy and safety between surgical and conservative treatments for hemorrhoids: a meta-analysis
Longfang Quan, Xuelian Bai, Fang Cheng, Jin Chen, Hangkun Ma, Pengfei Wang, Ling Yao, Shaosheng Bei, Xiaoqiang Jia
BMC Gastroenterology.2025;[Epub] CrossRef
A Comparative Study of Stapler and Laser Hemorrhoidoplasty in the Treatment of Second-Degree and Third-Degree Hemorrhoids
Hemant Bhanarkar, Ashutosh D Jadhao, Bhupesh Tirpude, Vikrant Akulwar, Gayatri Deshpande, Raj Gajbhiye, Nikita Monteiro
Cureus.2025;[Epub] CrossRef
Laser hemorrhoidoplasty in focus: A modern alternative to conventional surgical techniques for symptomatic hemorrhoids
Alfadl Abdulfattah, Fabricio Doin Paz de Oliveira
World Journal of Surgical Procedures.2025;[Epub] CrossRef
Evaluating Laser Haemorrhoidoplasty as a Short-Term Approach to Advanced Haemorrhoidal Disease
Chin Kiat Tan, Shou Kee Ng, Arijit Mukherjee
Cureus.2025;[Epub] CrossRef
The Outcome of Laser Ablation Hemorrhoidoplasty versus Conventional Hemorrhoidectomy
Mohammed Yousef Alessa, Loai Saleh Albinsaad, Arshadullah Khan, Laila Zamil Alzamil, Raghad Mabrouk Alanazi, Najd Mabrouk Alanazi, Abeer Mabrouk Alanazi
Annals of African Medicine.2025; 24(4): 811. CrossRef
Taiwan society of colon and rectal surgeons’ consensus on the management of hemorrhoidal disease
Tsung-Kun Chang, Tao-Wei Ke, Pao-Shiu Hsieh, Shih-Ching Chang, Wan Hsiang Hu, Ching-Wen Huang, Feng-Fan Chiang, Hsiang-Lin Tsai, Jin-Tung Liang, Chien-Kuo Liu, Jaw-Yuan Wang
International Journal of Colorectal Disease.2025;[Epub] CrossRef
Patient-reported outcomes after hemorrhoid surgery: early results from a prospective, nationwide, real-world, cohort study on diverse approaches
Metin Kement, Atıf Tekin, Hakan Baysal, Salih Tosun, Orhan Alimoğlu, İlker Sücüllü, Osman Civil, Nevin Sakoğlu, Naciye Çiğdem Arslan, Cihad Tatar, Ali Emre Naycı, Aziz Arı, Ensar Çakır, Rozan Kaya, İlknur Turan, Taygun Gülşen, Serhat Meriç, Erkan Yavuz, N
Annals of Coloproctology.2025; 41(6): 573. CrossRef
Cryotherapy reduces pain post-hemorrhoidectomy (CYPHER): a randomized, controlled, superiority trial of intra-anal ice after surgery for grade III hemorrhoids
Isaac Seow-En, Lionel Raphael Hui Chen, Yun Zhao, Yvonne Ying-Ru Ng, Emile Kwong-Wei Tan
Annals of Coloproctology.2025; 41(6): 537. CrossRef
Laser Hemorrhoidoplasty: Postoperative Outcomes and Predictive Factors for Pain, Bleeding, and Recovery
Laurențiu Augustus Barbu, Nicolae-Dragoș Mărgăritescu, Liliana Cercelaru, Tiberiu Stefăniță Țenea Cojan, Mădălina Costinela Stănică, Irina Enăchescu, Ana-Maria Țenea Cojan, Valentina Căluianu, Gabriel Florin Răzvan Mogoș, Liviu Vasile
Life.2025; 15(11): 1777. CrossRef
Short-term and patient-reported outcomes of laser hemorrhoidoplasty plus excisional hemorrhoidectomy for the treatment of grade IV hemorrhoid
Yu-Tso Liao, Kai-Shing Chang, Bin-Chin Wu, Wan-Xin Cheng, Ho-Hsien Chuan, Kai-Wen Huang, Jin-Tung Liang
Scientific Reports.2025;[Epub] CrossRef
Quand et comment traiter des hémorroïdes
Thierry Higuero
La Presse Médicale Formation.2024; 5(1): 24. CrossRef
Spectrum of Diagnoses in Female Patients With Proctologic Symptoms Presenting to the Surgery Unit of a Tertiary Care Center
Sana Sahar, Tamjeed Gul, Muhammad Ihtesham Khan
Cureus.2024;[Epub] CrossRef
Precision and Power: A Comprehensive Review of Exploring the Role of Laser Treatment in Hemorrhoidal Management
Dheeraj Surya, Pankaj Gharde
Cureus.2024;[Epub] CrossRef
Diode laser hemorrhoidoplasty versus conventional Milligan-Morgan and Ferguson hemorrhoidectomy for symptomatic hemorrhoids: Meta-analysis
Po-Lung Cheng, Chang-Cyuan Chen, Jian-Syun Chen, Po-Li Wei, Yan-Jiun Huang
Asian Journal of Surgery.2024; 47(11): 4681. CrossRef
Laser hemorrhoidoplasty vs. rubber band ligation: a randomized trial comparing 2 mini-invasive treatment for grade II hemorrhoids
Lei Jin, Kaijian Qin, Renjie Wu, Haojie Yang, Can Cui, Zhenyi Wang, Jiong Wu
BMC Surgery.2024;[Epub] CrossRef
Quality of Life of Patients Before and After Hemorrhoid Surgery: A Single-Center Study in Vietnam
Nguyen Thi Thuy Anh, Nguyen Ngoc Huynh Nhu, Tran Ngoc Hong, Pham Thi Ly, Nguyen Thi Hong Huyen, Doan Thi Minh, Ho Tat Bang, Nguyen Trung Tin
Journal of Nursing and Midwifery Sciences.2024;[Epub] CrossRef
Propensity-Score Matching Analysis for Laser Hemorrhoidoplasty Versus Circumferential Stapler Hemorrhoidectomy: One-Year Outcomes
Tran V Hung, Duong V Hai
Cureus.2024;[Epub] CrossRef
Outcomes of laser hemorrhoidoplasty for grade II–IV hemorrhoidal disease in Bangladesh
Md. Saiful Islam, Abhigan B. Shrestha, Faisal Chowdhury, Md. R.K. Ziko
Annals of Medicine & Surgery.2024; 86(11): 6514. CrossRef
Lower pain, less itching, and faster healing after ultrasound scalpel-assisted hemorrhoidectomy using an intimate cleaner containing chlorhexidine, acid hyaluronic acid, and natural anti-inflammatories: a multicenter observational case-control study
Antonio Brillantino, Luigi Marano, Maurizio Grillo, Alessio Palumbo, Fabrizio Foroni, Luciano Vicenzo, Alessio Antropoli, Michele Lanza, Maria Laura Sandoval Sotelo, Nicola Sangiuliano, Mauro Maglio, Rosanna Filosa, Lucia Abbatiello, Maria Preziosa Romano
Annals of Coloproctology.2024; 40(6): 602. CrossRef
Minimally invasive laser technologies in the surgical treatment of hemorrhoidal disease: problems and prospects (literature review)
N. D. Yartseva, L. V. Kornev, E. K. Naumov, G. V. Rodoman, L. A. Laberko
Hirurg (Surgeon).2023; (3): 20. CrossRef
Laser interventions in coloproctology. A plea for standardized treatment protocols
P. C. Ambe
Techniques in Coloproctology.2023; 27(10): 953. CrossRef
Comments on “Laser hemorrhoidoplasty versus conventional hemorrhoidectomy for grade II/III hemorrhoids: a systematic review and meta-analysis”
Mohamed Ali Chaouch, Amine Gouader, Bassem Krimi, Hani Oweira
Annals of Coloproctology.2023; 39(5): 442. CrossRef

First
Prev
Page of 1
Next
Last

Search