Comparative Study between Milligan Morgan Versus Ligasure Haemorrhoidectomy

Abstract

Purpose of Study: To compare the short term outcome of Ligasure haemorrhoidectomy with Milligan Morgan technique for third and fourth degree haemorrhoids. Design of Study: The present study was a single-blind randomized controlled trial. Duration and Location of Study: This trial was conducted at Akhtar Saeed Trust Teaching Hospital, Lahore. Duration of study is 6 months June 2021 to December 2021. Patients and Methods: A total of 80 subjects suffering from 3rd or 4th degree haemorrhoids were enrolled in the study and divided into two groups using lottery method. An informed written consent was taken from all the patients. Patients in group A (LS group) underwent Ligasure haemorrhoidectomy while patients in group B (MM group) underwent Milligan Morgan haemorrhoidectomy. Mean and standard deviation was calculated for numerical variables like age, operation time and postoperative pain on VAS score. Frequency and percentage was calculated categorical variables like gender, disease severity, bleeding, occurrence of urinary retention, anal stenosis and necrosis. SPSS version 22.0 was used for data analysis. Results of the Study: The patients had a mean age of 41.54±6.380 years within age range of 35-62 years. Number of male participants was high as 49 (61.3%) while compared with females who were 31 (38.7%) in total study sample of 80 subjects with a male to female ratio of 1.58:1. Number of patients with 3rd degree haemorrhoids was 53 (66.3%) whereas 27 (33.8%) patients had 4th degree haemorrhoids. LS was found to have significantly less operation time as 15.03±1.928 vs. 20.40±2.228 minutes; p-value=0.000. Postoperative pain was significantly less in LS group than MM group (4.20±0.883 vs. 5.23±0.891; p-value=0.000). Frequency of postoperative bleeding was also significantly less in LS group than MM group (5.0% vs. 25.0%; p-value=0.013). Occurrence of urinary retention was high in the LS group but the difference was not significant (p=0.247). Frequency of anal stenosis and necrosis was also less in LS group than MM group but the difference was not statistically significant with p-value=0.077 and 0.500, respectively. Conclusion: Ligasure haemorrhoidectomy was found superior to Milligan Morgan hemorrhoidectomy in managing patients with third and fourth degree haemorrhoids because it has considerably less operation time, postoperative pain and bleeding. Thus, Ligasure haemorrhoidectomy should be favored in the treatment of such cases in future surgical practice on the basis of benefits of Ligasure haemorrhoidectomy. Keywords: Hemorrhoids, Ligasure Haemorrhoidectomy, Milligan Morgan Hemorrhoidectomy

Comparative Study of Placebo Versus Metronidazole as a Role of Pain Relief Post Hemorrhoidectomy

“…On the other hand, Aljabery RMS et al 13 , reported the mean age of their subjects was 38.9 years, with they also found males in majority 66.66% and females 33.44%. Another study by Baig AA et al 14 reported that the average age of their subjects was 41.54±6.380 years, with males being the most common at 61.3% and females at 38.7%. Although the exact cause of male predominance in hemorrhoids is not well understood, lifestyle factors like diet, obesity, and lack of physical activity may play a role, and occupational hazards like long periods of sitting or heavy lifting may also contribute to the development of hemorrhoids.…”

Laser Hemorrhoidoplasty Versus Ligasure Hemorrhoidectomy: A Comparative Analysis

“…It has been shown to be effective in reducing anal spasms and pain after hemorrhoidectomy [ 4 ]. In addition, It has been associated with significantly less surgical time and bleeding compared to traditional hemorrhoidectomy [ 5 ].…”