Work

Laser Hemorrhoidoplasty: Postoperative Outcomes and Predictive Factors for Pain, Bleeding, and Recovery

Year: 2025

Type: article

Abstract: Background: Laser hemorrhoidoplasty (LHP) is a minimally invasive alternative to excisional hemorrhoidectomy, with promising short-term outcomes. However, predictors of postoperative pain, bleeding, and recovery remain insufficiently characterized. Methods: We conducted a prospective study including 140 patients with Goligher grade I–IV hemorrhoidal disease (January 2020–December 2024) at Independența Vita Plus Hospital, Craiova. All patients received preoperative diosmin and topical ointments. Procedures were performed under spinal anesthesia using a standardized 1470 nm diode laser technique. Outcomes included postoperative pain (VAS), bleeding, early and late complications, recovery time, HDSS change, and quality of life assessed with a simple 0–10 numerical scale used in routine clinical practice (not a validated QoL instrument). Results: Mean operative time was 17.9 ± 4.8 min, with minimal blood loss. Postoperative bleeding occurred in 28.6% and was mild. Early complications increased with disease stage: 10% (II), 53% (III), 68% (IV) (p < 0.001). VAS pain decreased from 2.1 on day 1 to 0.3 on day 7 (p < 0.0001). Median recovery time was 3 days, longer in advanced stages. HDSS improved from 10.3 ± 2.5 preoperatively to 1.7 ± 1.1 at 3 months (p < 0.0001). QoL numerical scores also improved significantly at 3 months. Goligher grade independently predicted late bleeding (OR 70.2), high pain (OR 4.9), and prolonged recovery (OR 8.6). No recurrences were observed at 12 months. Conclusions: LHP provides low postoperative pain, minimal bleeding, rapid recovery, and significant symptom and QoL improvement. Disease severity strongly predicts outcomes and should guide perioperative planning.

Source: Life

DOI: 10.3390/life15111777