AIM: to assess the learning curve of implementation of laser vaporization for hemorrhoids.PATIENTS AND METHODS: laser vaporization was performed by one surgeon for 378 patients, which had no personal experience of implementation of this technique before. CUSUM method was used to analyze the duration of the training period.RESULTS: the two-fold decrease of negative results percentage was obtained after 40 procedures. During the training period, 7 (17.5%) unfavorable outcomes were revealed and 17 (5.0%) — during consolidation of experience (p = 0.008). Difference in outcomes between vaporizations only and combined interventions was not significant.CONCLUSION: the learning curve for implementation of laser vaporization for hemorrhoids determined by the СUSUM analysis method is 40 cases. The risk of unfavorable results is not associated with the volume of procedure, but with the training period.

AIM: to assess of the results of transmucosal laser ablation (TMLA) for internal piles and simultaneous elimination of external piles in patients with combined hemorrhoids of 2–3 stages.PATIENTS AND METHODS: the retrospective study included 226 patients. TMLA of internal nodes with excision or destruction of external piles was performed in 136 patients (the main group) and 90 laser destructions of internal nodes only consisted the control group. The procedure was performed under local anesthesia on a Lakhta-Milon device with a wavelength of 1.47 μm with a power of 8.0 W. The operation time, the pain syndrome, its duration after surgery, the complication rate and the recurrence rate up to 18 months were estimated.RESULTS: the operation time in the main group was 15.0 minutes (10 min in control group; p = 0.001), the pain intensity during procedure was determined by patients at 2.5 points of VAS (2.5 — in controls; p = 0.81). Postoperative pain was detected up to 6 days (5 days in controls; p = 0.44). Postoperative bleeding occurred in 4 (2.9%) (8 — in controls; p = 0.051), recurrence occurred in 3 (4.8%) patients after 12 months (1 patient in controls; p = 0.5).СONCLUSION: TMLA has a good tolerability and good late results, which is the motivation for wide implementation for patients with hemorrhoids in outpatient basis.

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