Standardization Reduces Recurrence and Overall Complication Rate in Laser Haemorrhoidoplasty: Retrospective Cohort Study

Background: The laser hemorrhoidoplasty procedure is a minimally invasive technique for treating symptomatic hemorrhoids. This study aimed to assess the safety of laser hemorrhoidoplasty and to study long-term recurrence rates and other complications. Methods: In this retrospective, single-center study, 250 consecutive symptomatic patients of internal hemorrhoids of grade I-IV underwent laser hemorrhoidoplasty. The procedure was done using a 15 W, 1470 nm diode laser machine (Lasotronix). All the preoperative and postoperative variables were analyzed, with special emphasis on post-procedural pain, complications, and recurrence rate. Follow-up was scheduled on the 4th, 7th, and 30th day, then at 3, 6, and 12 months, and once a year thereafter. Complications were recorded. Results: There were 250 patients (134 male and 116 female; mean age: 43.72±18.34 years, range 16-85 years). Short-term follow-up was achieved for all patients. Patient satisfaction in terms of pain at rest and post-defecation pain was 100%. Twenty eight patients (11.2%) had complications: 10 (4%) had postoperative bleeding, 3 (1.2%) had infection, 1 (0.4%) developed a fistula-in-ano, 1 (0.4%) developed a thrombosed hemorrhoid, 1 (0.4%) had a prolapsed hemorrhoid, 5 (2%) had incomplete regression, and 1 patient (0.4%) had a fissure in ano. Ulceration occurred in 1 patient (0.4%), while 2 patients (0.8%) developed recurrence. No anal stenosis or fecal incontinence occurred in any of the patients. Conclusion: This study shows that laser hemorrhoidoplasty gave 100% patient satisfaction in terms of post-procedure pain at rest and post-defecation pain. With standardization, laser hemorrhoidoplasty is a safe procedure with good short-term and long-term results and minimal recurrence.