Laser in Management of Third Degree Piles

Background: Symptomatic hemorrhoids are treated using a combination of non-surgical treatments, conservative medical management, and various surgical procedures. In the past, hemorrhoidectomy and its closed variation method constituted the bulk of open surgical procedures. Complications, pain, and discomfort following surgery are common with these two approaches. Laser treatments for hemorrhoids of Grade II and III have shown a range of 83.6% to 100% relief in symptoms in prior research. Aim of the study: This research focused on the application of laser technology in treating third-degree piles. Patient and methods: The prospective investigation was carried out at a specialized hospital in Egypt from January 2022 to January 2023, involving a total of 200 patients, comprising 90 (45%) females and 110 (55%) males, with an average age of 45±2.45 years. The follow-up duration for these patients was 1.55±0.50 years. Adult individuals aged 17 to 70 with third-degree hemorrhoids, featuring minimal or no mucosal prolapse, were selected, particularly those who had not responded to conservative treatments. Results: The findings indicated that 75% of patients experienced grade hemorrhoid symptoms, with bleeding reported in 160 (80%) participants, and hemorrhoidal syndrome noted in 50 (25%) of the cases. Furthermore, prolapsed hemorrhoids were observed in 100 (50%) patients, and thrombosed hemorrhoids were noted in 20 (10%) individuals. Conclusion: Second- and third-degree hemorrhoids are effectively treated with the He-LP method, which has a short operation and recovery time, can be done in a day surgery environment, causes low intra- and postoperative discomfort, and significantly improves symptoms. More invasive therapies for early-stage HD may not be necessary with this approach.