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LIGASURE HEMORRHOIDECTOMY VS CONVENTIONAL MILLIGAN MORGAN HEMORRHOIDECTOMY: A COMPARISON FOR BETTER OUTCOME IN 3RD AND 4TH DEGREE HEMORRHOIDS

. Shiraz Shaikh, Zameer Hussain Laghari, Aisha Memon, Bilal Rasool, Qamber Ali Laghari & Awais Iqbal Bhatti


Abstract

Objective: To compare the outcome of two techniques for 3rd and 4th degree hemorrhoids, i.e., Milligan Morgan hemorrhoidectomy (MMH) and Ligasure hemorrhoidectomy (LH), in terms of bleeding, postoperative pain, and hospital stay.

Subjects and methods: This comparative study was conducted at the Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro. All the patients undergoing hemorrhoidectomies for the treatment of 3rd and 4th degree hemorrhoids, the patient's willingness and ability to comply with post-operative instructions and follow-up care, aged more than 12 years and both genders, and those who understanding of the risks and benefits of the surgery were included. After obtaining informed consent, the patients were divided into two groups. In first group, patient underwent ligasure hemorrhoidectomy, while second group operated with Milligan Morgan technique. All the demographic information, including operative details, postoperative pain, hospital stay, and follow-up, was recorded via the study proforma. SPSS version 26 was used for the data analysis.

Results: A total of 62 patients with 3rd and 4th degree hemorrhoids were compared as per treatment; their overall mean age was 41.01+14.45 years. Males were 67.7% and females were 32.3%. Third-degree hemorrhoids was most common in both groups. In the LH group, average operative time was 16.74+2.19 minutes, which was significantly lower as compared to the MMH group as 35.42+4.47 minutes (p=0.001). Anal stenosis was developed in one case in the LH group and in two cases in the MMH group (p-0.001). Although average VAS was significantly lower in the LH group compared to the MMH group on day 1 and day 7 after surgery (p = 0.001). Furthermore, the average hospital stay was also significantly lower in the LH group as compared to the MMH group (p=0.001).

Conclusion: LigaSure hemorrhoidectomy was observed to be safe and effective in terms of being less invasive, having a shorter recovery time, and causing less pain and having a lower bleeding risk compared to conventional Milligan Morgan hemorrhoidectomy.

Key words: hemorrhoidectomy, MMH, LH, pain, operative time, bleeding, hospital stay.

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