Abstract
Background
Hemorrhoidal disease is still one of the most common anorectal disorders seen in clinical practice. Many of patients come in with pain, bleeding, or prolapse. In more severe situations, especially grades three and four surgery, it is still the most reliable way to manage the problem. The Milligan Morgan (ММ.) hemorrhoidectomy has long been seen as the best way to treat such patients.
The LigaSure approach has more attention in the last several years. This gadget uses bipolar electrothermal energy to close vessels and cut out tissue at the same time.
Aim
The study aimed. to compare outcomes between LigaSure hemorrhoidectomy and the traditional Milligan Morgan operation. the execution of the procedure, postoperative recovery, complication rates, patient satisfaction, and the comparative cost. Effectiveness.
Methods
The study included 500 adult patients, diagnosed with grade three or four hemorrhoidal illness who underwent surgery, at Baqubah teaching Hospital and Other private hospital from first of January to the end of December 2023. The 500 people who took part were split into two groups: 250 had the LigaSure hemorrhoidectomy and 250 had the Milligan. Morgan operation. All surgeries were done under spinal anesthesia, Data gathering involved including criteria age (18-75) years in grade III or IV hemorrhoidal disease. and excluded criteria patient with another coexisting anorectal condition (anal fissure, abscesses, or fistula). had anorectal surgery within the past six month. pregnant or lactating Woman. And contraindication to spinal anesthesia, and performing follow-up visits, so. guaranteeing an accurate account of each patient. postoperative experience. The main things that were looked at were the length of the operation, the amount of blood lost during the operation, the amount of discomfort after the operation, ,the usage of painkillers, the time it took for the patient to recover, any problems that came up, and how satisfied the patient was with the surgery. The data were analyzed with SPSS, and a p-value of less than 0.05 was used to determine statistical significance
Results
The LigaSure technique showed clear intraoperative advantages. Surgery time was notably shorter (35.4 ± 8.2 min vs. 50.7 ± 10.5 min, p < 0.001), and average blood loss was reduced by half (150 ± 30 mL vs. 300 ± 50 mL, p < 0.001).
Postoperative recovery, trends were also better. Patients who underwent LigaSure reported consistently lower pain scores on all measured days—day 1 (3.2 ± 1.0 vs. 5.8 ± 1.5), day 3 (2.1 ± 0.8 vs. 4.0 ± 1.2), and day 7 (1.0 ± 0.5 vs. 2.5 ± 0.9), all with p < 0.001.. Correspondingly, their analgesic requirements were significantly lower (30 ± 10 mg vs. 70 ± 15 mg morphine equivalents, p < 0.001).
Recovery milestones reflected similar improvement: most LigaSure patients resumed normal activity within one week (7 ± 2 days) compared to two weeks for the ММ group (14 ± 3 days, p < 0.001). Hospital stays were shorter as well (2.5 ± 0.8 days vs. 4.0 ± 1.2 days, p < 0.001).
After LigaSure, complications happened at lower rates. (5%) than after MM (12%, p < 0.001). The LigaSure group had fewer cases of wound infection (2% vs. 4.8%), urine retention (0.8% vs. 2.4%), anal stenosis (0.8% vs. 2.0%), and postoperative hemorrhage (1.2% vs. 2.4%). Recurrence was also reduced (3% vs. 6%, p = 0.032).
Patients expressed higher satisfaction scores (85 ± 10 vs. 70 ± 15, p < 0.001). Many reported faster relief, improved mobility, and a smoother postoperative course, all of which made their quality of life seem better.
Key words: ligasure hemorrhoidectomy. Milligan morgan hemorrhoidectomy
Funding sources: self-funding
Conclusion
LigaSure a good choice for advanced hemorrhoidal disease. For it is
lower complication rate and higher satisfaction levels, along with less resource use.
