BACKGROUND: Open hemorrhoidectomy remains the gold standard for the surgical treatment of hemorrhoidal disease but is associated with substantial postoperative pain and complications. In contrast, Laser Hemorrhoidoplasty (LHP) has emerged as a minimally invasive alternative. This study aimed to evaluate the clinical outcomes, complication and recurrence rates of LHP in a single-center cohort. METHODS: This retrospective study included 132 patients (72 % male, mean age 52.8 years) with grade II-IV hemorrhoidal disease who underwent Laser Hemorrhoidoplasty in our center between January 2021 and June 2025. Postoperative pain, complications, patient satisfaction, and recurrence rates were analyzed. Univariable and multivariable logistic regression analyses were performed to identify associations with recurrence and complications. RESULTS: Postoperative pain scores were low, with a median Visual Analogue Scale (VAS) score of zero at discharge, after one week and after one month. Most patients (94.7 %) were discharged on the day of surgery, and 95.5 % reported satisfaction with the postoperative outcome. Postoperative complications occurred in twelve patients (9.1 %), including three readmissions (2.3 %) and one reintervention (0.8 %). Overall recurrence occurred in thirteen patients (9.8 %), while five patients (3.8 %) required surgical treatment. Higher hemorrhoidal grade was significantly associated with recurrence, whereas no association was observed with postoperative complications. In multivariable analysis, grade IV hemorrhoids were independently associated with increased odds of recurrence after adjustment for age and previous treatment. CONCLUSION: Within this cohort, LHP may represent a safe and minimally invasive treatment option for hemorrhoidal disease associated with generally low postoperative pain, favorable patient satisfaction and relatively short hospital stay. Complication and readmission rates were low. However, grade IV disease was independently associated with increased recurrence after adjustment for age and previous treatment, indicating that caution is warranted in this subgroup. Further prospective studies with larger sample sizes, comparison group and longer follow-up are needed to better define the role of LHP in advanced hemorrhoidal disease.
Heynderickx et al. (Thu,) studied this question.