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.