Hemorrhoid laser procedure for second- and third-degree hemorrhoids: results from a multicenter prospective study

Tech Coloproctol. 2016 Jul;20(7):455-9. doi: 10.1007/s10151-016-1479-6. Epub 2016 May 11.


Background: The aim of our study was to assess the outcome of hemorrhoidal dearterialization, achieved by a dedicated laser energy device.

Methods: From November 2012 to December 2014, 51 patients with second- or third-degree hemorrhoids were studied. The primary end point was a reduction in the bleeding rate; secondary end points were: postoperative complications, reduction in pain and prolapse, resolution of symptoms, and degree of patient's perception of improvement. The procedure was carried out as 1-day surgery. A diode laser device was employed to seal the terminal branches of the hemorrhoidal arteries, detected by a Doppler-equipped proctoscope. Follow-up was scheduled at 1 and 4 weeks, 3, 12, and 24 months. The rate and degree of symptoms was assessed with a four-point verbal rating scale. The rate of subjective symptomatic improvement was also evaluated with the Patient Global Improvement (PGI) Scale.

Results: Mean bleeding and pain scores at baseline were 2 and 0.57. All the patients were discharged on the day of surgery. Postoperative complications were bleeding (n = 4) and external hemorrhoidal thrombosis (n = 4). Mean bleeding and pain scores at 3, 12, and 24 months were significatively reduced. After 24 months, complete resolution of bleeding was observed in 28/29 patients (96.7 %), resolution of pain in all patients, and resolution of the mucosal prolapse in 15/18 patients (76.9 %). At 12-month follow-up, 86.3 % of patients reported improvement with the PGI Scale.

Conclusions: The hemorrhoid laser procedure was effective in improving bleeding and pain symptoms in patients with grade II and III hemorrhoids.

Keywords: Dearterialization; Doppler-guided artery ligation; HeLP; Hemorrhoids; Patient Global Improvement Scale.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Endosonography
  • Female
  • Follow-Up Studies
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / prevention & control*
  • Hemorrhoidectomy / methods*
  • Hemorrhoids / complications
  • Hemorrhoids / diagnostic imaging
  • Hemorrhoids / surgery*
  • Humans
  • Lasers, Semiconductor / therapeutic use*
  • Male
  • Middle Aged
  • Pain / etiology
  • Pain / prevention & control*
  • Proctoscopy
  • Prolapse
  • Prospective Studies
  • Severity of Illness Index
  • Treatment Outcome
  • Ultrasonography, Doppler
  • Young Adult