Short Term Outcomes of Laser Pile Ablation (LPA) to Treat II-III Degree Symptomatic Hemorrhoidal Disease

This study aimed to assess the outcomes of Laser Pile Ablation (LPA) in patients affected by IIIII degree symptomatic hemorrhoidal disease (HD). Methods: Consecutive patients suffering from II-III degree symptomatic HD were enrolled to undergo LPA. The primary study endpoint was to assess postoperative pain according to both the numerical rating scale (NRS; 0-10) and the painkiller use. Secondary endpoints were intraoperative and postoperative complications and the recurrence rate (including bleeding and prolapse). Patient satisfaction was assessed at 6 and 12 months using a visual analog scale (VAS; 0-10) and by asking the patients whether they would undergo the procedure again and recommend it to a relative or friend. Results: Twenty-five patients (7F–18M) were enrolled in the study. All the procedures were performed under spinal anesthesia and the mean amount of energy delivered was 472.6±50.7 J. The mean follow-up was 9 months (range 6-12). Mean postoperative pain (NRS) was 4.7±1.5 at 12 h, 4.4±1.3 at 24 h, and 2.2±1.0 at day 10. Pain was generally managed with paracetamol, with only 30.7 % requiring NSAIDs. The recurrence rate was 7.7% at 3 and 6 months after the procedure. The mean time interval to return to work was 2.7±2.1 days. All the patients were extremely satisfied with the procedure (VAS=9). Conclusion: LPA is a safe, effective, and minimally invasive procedure for treating II-III degree HD with optimal management of postoperative pain and excellent patient satisfaction.