Abstract
Objective:To compare the efficacy of haemorrhoidectomy done by using LigaSure with conventional Milligan Morgan haemorrhoidectomy.Methods:This randomized controlled trial was done at Department of Surgery Dow University Hospital Karachi during January 2013 to September 2015. A total of 55 patients were included in the study. Patients were randomly allocated to group A (Haemorrhoidectomy by Ligasure) and group B (Milligan Morgan Haemorrhoiectomy). Efficacies of both procedures were compared by operative time, Blood loss, wound healing, and pain score on immediate, 1st and 7th post operative day.Results:Out of total 55 patients 23 were male and 32 were females. The most common group of age involved was between 40 – 60 years. Third degree Heamorrhoids were present in 37 (67.3%) of patients while remaining 18 (32.7%) had fourth degree Heamorrhoids. Group A included 29 cases while Group B included 26 cases. The mean operating time of Group A was 52.5 with standard deviation of 11.9 while it was 36.6± 9.8 in the other group. The mean blood loss in group A was 51.92 with standard deviation of 15.68 while it was 70.34±25.59 in group B. Overall pain score was less in those patients who underwent Heamorrhoidectomy by Ligasure method.Conclusion:The efficacy of Heamorrhoidectomy by Ligasure is better than the traditional Milligan Morgan Heamorrhoidectomy but we need more clinical trials with large sample size and long term follow ups.
Highlights
Hemorrhoids, a varicose condition is one of the commonest illnesses which causes per rectal bleeding.[1]
Traditional Milligan Morgan haemorrhoidectomy is the open surgical procedure in which the haemorrhoid pedicle is ligated by a transfixing suture which may lead to some postoperative complications mostly pain, bleeding and wound infection which cause prolonged stay in hospital
All patients with ages between 18 to 70 years of both genders with third and fourth degree Haemorrhoids admitted in department of general surgery of Dow University Hospital planned for Surgery, giving informed consent for haemorrhoidectomy done by using LigaSure and conventional Milligan Morgan haemorrhoidectomy were included in the study
Summary
Hemorrhoids, a varicose condition is one of the commonest illnesses which causes per rectal bleeding.[1]. Traditional Milligan Morgan haemorrhoidectomy is the open surgical procedure in which the haemorrhoid pedicle is ligated by a transfixing suture which may lead to some postoperative complications mostly pain, bleeding and wound infection which cause prolonged stay in hospital. A number of surgeons believe that by avoiding vascular pedicle ligation the chances of secondary bleeding can be decreased. The reason behind this is belief that it may lead to ischaemia and necrosis at the region where these sutures are applied it may integrate the sphincter muscle and causes acute postoperative pain, wound infection and bleeding. Many authors have said that we do not transfix vascular pedicles of haemorrhoids, but we seal them by LigaSure.[7]
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