Comparison of Pedicle Coagulation Haemorrhoidectomy with Ligasure vs Conventional Milligan Morgan Haemorrhoidectomy in Reducing Post-Operative Pain among Patients of 3rd and 4th Degree Haemorrhoids: a Randomised Controlled Trial

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Background: Hemorrhoids refer to the abnormal enlargement of the anal cushions. They are a common anorectal problem with a prevalence of 5% in the general population aged greater than 40 years. The objective of this study was to compare Milligan Morgan open hemorrhoidectomy with pedicle ligation with LigaSure in terms of postoperative pain on day 1 and day 7. Materials and methods: It was a randomised controlled trial conducted in Department of surgery, Rawalpindi, Pakistan. A total of 100 patients were selected and were allotted into the two groups by lottery method. Patients aging from 15 to 60 years who presented with the symptomatic third, and fourth-degree hemorrhoids were included after taking informed consent. Patients who had a previous or concomitant anorectal disease, patients who had undergone previous surgery for hemorrhoids and those who were anesthetically unfit for surgery (American Society of Anesthesiologists (ASA) class 3 or above) were excluded from the study. Data was entered and analyzed using SPSS v. 23.0. Chi-square tests were applied. P-value <0.05 was taken statistically significant. Results: Out of 100 patients, 68 (68%) were males while 32 (32%) were females. Mean age was 40.56±9.24 years. Postoperative pain at day 1 was 9.24±0.51 in Milligan Morgan group while that in LigaSure group was 8.44±0.64 (p less than0.0001). Postoperative pain at day 7 was 5.00±0.85 in Milligan Morgan group while it was 3.04±1.08 in LigaSure group (p<0.0001). Conclusion: Postoperative pain is much lower in the LigaSure group as compared to Milligan Morgan open hemorrhoidectomy.