Outcomes of laser hemorrhoidoplasty for grade II–IV hemorrhoidal disease in Bangladesh

Abstract

Background: Laser hemorrhoidoplasty is a minimal invasive procedure to treat hemorrhoids and has shown better outcomes. Less is known about its utility in a Lower middle-income country; Bangladesh. Method: Between March 2023 and December 2023, 86 patients with grade II-IV hemorrhoids underwent laser hemorroidoplasty. Follow up was assessed on 1st week, 2nd week and 6th weeks including pain, satisfaction, symptom improvement, incapacity for work, complications, reduction and recurrence. Results: The study included 86 patients, with a higher proportion of male participants (73.3%) with a mean age of 55.43±13.6 years. The majority of subjects (68.60%) had Grade 3 hemorrhoids. The average surgery duration was 14.70±4.70 minutes. All individuals experienced substantial decreases in the size of their hemorrhoids (100%) and reported high levels of satisfaction after the operation (97.7%). The use of the Wilcoxon signed-rank test demonstrated a statistically significant reduction in both the Visual Analog Scale (VAS) and Patient Global Impression of Improvement (PGI-I) ratings during the three subsequent observation periods( 1st week, 2nd week, and 6 wks). The 6th week complication rate was 19.8%. Additional mucopexy was performed on all patients with Grade IV and three patients with Grade III hemorrhoids. Conclusion: Laser hemorroidoplasty is a day-care procedure, that is safe and efficacious and can be used in rural area settings with good patient satisfaction. Mucopexy is required in some cases of large hemorrhoidal mass to prevent recurrence.