Comparison of Doppler Guided Hemorrhoid Artery Ligation and Milligan Morgan Hemorrhoidectomy in Management of Hemorrhoidal Disease

Abstract

Background: Hemorrhoidal disease is the most common rectal disorder, and many modalities have been suggested for its treatment. Objectives: In this study, we compared Doppler-guided Hemorrhoid Artery Ligation, one of the newest techniques in the treatment of this disease, to the Milligan-Morgan Hemorrhoidectomy (open Hemorrhoidectomy). Patients and Methods: One hundred patients were enrolled in this study and divided randomly into two groups of fifty patients. Each group either underwent the Milligan-Morgan procedure or the Doppler-guided Hemorrhoid Artery Ligation method. The outcomes were compared using statistical methods. Results: Patient demographic results and symptomatology and the type of anesthesia used had no influence on the study results. The mean duration of the operation had no statistical difference. The major impact of this new method had less postoperative pain and more patient satisfaction. After a mean follow up of eighteen months, we had two cases of recurrence in the Doppler-guided Hemorrhoid Artery Ligation group with grade IV hemorrhoidal disease. Conclusions: Doppler-guided Hemorrhoid Artery Ligation is a safe and easy method for treating hemorrhoidal disease, but its results should be interpreted carefully, especially in grade IV of the disease.