Doppler-guided hemorrhoidal dearterialization with laser (HeLP): a prospective analysis of data from a multicenter...

Area of Science:

• Colorectal Surgery
• Minimally Invasive Procedures
• Gastroenterology

Background:

• Hemorrhoids are a common condition often treated with invasive procedures.
• Existing treatments may have significant side effects or limited efficacy.
• A minimally invasive approach is needed for symptomatic hemorrhoids resistant to medical therapy.

Purpose of the Study:

• To prospectively evaluate the clinical outcomes and patient satisfaction following the Doppler-guided hemorrhoidal laser procedure (HeLP).
• To assess the efficacy of HeLP in treating symptomatic hemorrhoids, focusing on symptom resolution and quality of life improvements.
• To identify potential factors associated with treatment failure.

Main Methods:

• A multicenter study involving 284 patients with symptomatic hemorrhoids treated with HeLP.
• Clinical efficacy assessed via symptom resolution, patient satisfaction scores, and validated scales for bleeding, acute symptoms, quality of life, and pain.
• Follow-up at 6 and 12 months, with recording of intra- and postoperative complications.

Main Results:

• High symptom resolution (90.5% at 6 months) and patient satisfaction (96.8% at 6 months) were observed.
• Statistically significant improvements in bleeding scores, acute symptoms, quality of life, and pain levels were documented (p < 0.0001).
• No significant changes in continence or constipation were noted, and no factors were significantly associated with treatment failure.

Conclusions:

• The HeLP procedure is a safe, effective, and minimally invasive option for symptomatic hemorrhoids.
• The procedure is associated with high patient satisfaction and can be performed in an ambulatory setting with minimal pain.
• HeLP may be considered a first-line treatment for patients with low-grade hemorrhoidal prolapse unresponsive to medical therapy.