Background: Hemorrhoidal disease is one of the most common anorectal conditions, significantly affecting quality of life.Current treatment trends are shifting toward minimally invasive techniques that preserve supporting tissues, reduce postoperative pain, and shorten recovery.Laser hemorrhoidoplasty (LHP) uses laser energy to vaporize, coagulate vessels, induce fibrosis, and reduce hemorrhoidal volume without excision.However, large-scale evidence on its efficacy and safety remains limited.Objectives: To evaluate the efficacy and safety of LHP, analyze factors affecting outcomes, and assess the role of TND's vertical ligation mucopexy (TVLM) combined with LHP.Methods: A retrospective descriptive study was conducted on 1,277 patients undergoing LHP at the Department of Colorectal and Pelvic Floor Surgery from September 2023 to February 2026.Results: Mean age was 45.55 ± 13.97 years; 53.2% were male; grade III hemorrhoids accounted for 59.5%.TVLM was performed in 58.7% of cases.Mean operative time was 35.05 ± 10.15 minutes; hospital stay was 1.27 ± 0.90 days.The mean number of treated piles was 3.54 ± 0.68, with energy of 273.5 ± 102.8 J/pile.Mean VAS decreased from 2.96 ± 0.29 (day 1) to 1.17 ± 0.41 (discharge) and 0.18 ± 0.54 (2 weeks).Intraoperative com-plications included bleeding (2.0%), mucosal perforation (0.9%), and burn (0.9%).Postoperative complications included bleeding (6.89%), urinary retention (2.5%), defecatory disorders (3.8%), thrombosis (0.3%), anal inflammation (11.5%), abscess (0.23%), and sepsis (0.1%).Recurrence was 1.4% at 10.69 months; reoperation 0.2%; readmission 3.5%.TVLM + LHP showed improved outcomes in complex cases.Conclusions: LHP is a safe, effective, minimally invasive technique with low pain, rapid recovery, and low complication rates.A stratified approach combining LHP with TVLM may represent a modern treatment trend.
Tran et al. (Wed,) studied this question.
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