Laser Hemorrhoidoplasty Procedure vs Open Surgical Hemorrhoidectomy a Trial Comparing 2 Treatments for Hemorrhoids of Third and Fourth Degree

Background: In the United States, hemorrhoid disease is the 4th most common outpatient gastrointestinal diagnosis, resulting in approximately 3.3 million ambulatory care visits. Its prevalence in Egypt was reported as 18%. Aim: To compare Laser Hemorrhoidoplasty (LHP) and Open Surgical Hemorrhoidectomy (OSH) for third- and fourth-degree hemorrhoids, focusing on pain, healing time, and recurrence.Patients and methods: This were a prospective comparative trial conducted on 80 patients. Cases have been separated into 2 groups: The Laser Hemorrhoidoplasty LHP group (number = 37) and the Open Surgical Hemorrhoidectomy OSH group (number = 43).Results: Insignificant variances have been detected in pain following surgery at weeks 4 and 5, degree of piles, or operative time (P-value more than 0.05). Nevertheless, significant variances have been observed in pain during the first three weeks, healing at weeks 2-4 (P < 0.05), and recurrence rates at six months (P = 0.04).Conclusion: LHP offers key advantages over OSH, including less postoperative pain, shorter operative time, and faster recovery, with most patients healing within three weeks. However, higher six-month recurrence rates with LHP require long-term monitoring. While OSH minimizes recurrence, its longer recovery and higher pain levels highlight trade-offs. LHP suits patients seeking quicker recovery and less discomfort, but careful patient selection and consideration of outcomes are vital.