Effectiveness of Laser Hemorrhoidoplasty in the Treatment of Hemorrhoidal Disease in Western Nepal: A Ambispective Descriptive study

Abstract

Introduction: Hemorrhoidal disease is a common anorectal condition causing pain, bleeding, and discomfort. Conventional hemorrhoidectomy, although effective, is associated with significant postoperative pain and delayed recovery. Laser hemorrhoidoplasty (LHP) has emerged as a minimally invasive alternative that aims to reduce morbidity while ensuring effective treatment. This study evaluated the short- and long-term effectiveness of LHP in patients with Grade II-IV hemorrhoids.

Methods: A total of 96 patients who underwent LHP at Manipal College of Medical Sciences (MCOMS), Pokhara between   1^st July 2023 to 30^th June 2024 were included in the study following ethical approval from institutional review board of MCOMS using convenience sampling. Retrospective data were obtained from hospital records, while prospective follow-up involved verbal and written informed consent. Long-term outcomes, including bleeding, recurrence, incontinence, anal stenosis, perianal fistula, and fissure, were assessed via follow-up and medical records.

Results: Of 96 patients, 65 (67.7%) were male and 31 (32.3%) were female. Grade III hemorrhoids were most common (61.5%), followed by Grade II (25.0%) and Grade IV (13.5%). Mean operative duration was 19.72 ± 3.19 minutes with minimal blood loss 9.8 ± 3.4 ml.  Postoperative bleeding and submucosal edema were more frequent in higher-grade hemorrhoids (p<0.001).

Conclusions: LHP is a safe and effective minimally invasive treatment for symptomatic hemorrhoids, providing rapid pain relief, minimal intraoperative blood loss, and quick return to daily activities. While short- and long-term outcomes are favorable for Grade II and III hemorrhoids, Grade IV patients require closer monitoring due to higher complication rates