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

Document Type : Research/Original Article


1 Proctology Unit, Private Hospital of Forlì, Forlì, Italy

2 Proctology and Pelvic Floor Clinical Centre, Cisanello University Hospital, Pisa, Italy


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?”.

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.

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.


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