Laser hemorrhoidoplasty (LHP) has emerged as a minimally invasive alternative for treating hemorrhoidal disease, particularly in grades III and IV. The outcomes of Laser hemorrhoidoplasty (LHP) have been evaluated in recent studies, assessing its efficacy and safety profiles in these advanced cases.
Outcomes in Grade III Hemorrhoids
LHP demonstrates favorable short-term results for grade III hemorrhoids. A study involving 50 patients reported a 98% reduction in hemorrhoidal stage and a 92% rate of complete or good symptom improvement at 60 days post-procedure. Postoperative pain was minimal, with 100% of patients reporting low pain scores by day 60. The study noted a 34% long-term recurrence rate over a mean follow-up of 5.4 years.
Outcomes in Grade IV Hemorrhoids
The effectiveness of LHP in grade IV hemorrhoids is comparatively limited. In a study of 162 patients, those with grade IV disease experienced higher postoperative complication rates, including bleeding (31.6%), readmissions (26.3%), and reoperations (21.1%). This group had a significantly higher recurrence rate compared to grades II and III.
Another study reported a 50% recurrence rate in grade IV patients over a 2-year follow-up period, suggesting that LHP may be less effective for severe hemorrhoidal disease .
Comparative Effectiveness
When compared to traditional excisional hemorrhoidectomy, LHP offers advantages such as reduced postoperative pain and quicker return to daily activities. However, the recurrence rates for LHP are higher, especially in advanced hemorrhoidal grades. Therefore, while LHP is a viable option for grade III hemorrhoids, we advise caution when considering it for grade IV cases.
Summary
| Hemorrhoid Grade | Symptom Improvement | Recurrence Rate | Complication Rate | Pain Level | Return to Activity |
|---|---|---|---|---|---|
| Grade III | High (92%) | Moderate (34%) | Low | Low | Quick |
| Grade IV | Moderate (50%) | High (50%) | High | Low | Quick |
Conclusion
In conclusion, Outcomes of Laser Hemorrhoidoplasty (LHP) show it to be an effective and less painful alternative to conventional surgery for grade III hemorrhoids. However, its efficacy diminishes in grade IV cases, where we observe higher complication and recurrence rates. Careful patient selection is crucial to improve outcomes.
