Short term outcomes of Laser Pile Ablation (LPA) to treat II-III degree symptomatic hemorrhoidal disease.

Abstract

Introduction The aim of this study is to assess the outcomes of Laser Pile Ablation (LPA) in patients affected by II-III degree symptomatic hemorrhoidal disease. Material and Methods Consecutive patients suffering of II-III degree symptomatic HD were enrolled to undergo LPA. The primary study endpoint was to assess the post-operative pain using NRS scale (0-10) and the use of painkiller. Secondary endpoints were: intraoperative, postoperative complications and recurrence rate (including bleeding and prolapse). Patients satisfaction was assessed at 6- and 12-months using VAS scale (0-10) and also through the questions “Would you undergo this surgery again?” and “Would you recommend this procedure 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, assessed through NRS scale, was 4.7±1.5 at 12 h, 4.4±1.3 at 24 h and 2.2±1.0 at day 10. The pain was managed with paracetamol 1 gr only 30.7 % required NSAIDs in addition for 3 days. Recurrence rate was 7.7% at 3 and 6 months after the procedure referring persistent bleeding. The mean time interval to return to work is 2.7±2.1 days. All the patients were extremely satisfied of the procedure VAS 9. Conclusion LPA resulted to be a safe, effective and minimally invasive procedure to treat II-III degree HD with optimal management of post-operative pain and excellent patient satisfaction.