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

Background: 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.