Hemorrhoids Second Degree, Hemorrhoids Third Degree, Internal Hemorrhoids
Conditions
Keywords
Laser Hemorrhoidoplasty, Milligan Morgan Hemorrhoidectomy, Randomized Controlled Trial, Postoperative Pain, Patient Satisfaction
Brief summary
Hemorrhoidal disease is one of the most common anorectal disorders. Conventional Milligan Morgan Hemorrhoidectomy remains the standard treatment but is associated with considerable postoperative pain. Laser Hemorrhoidoplasty has emerged as a minimally invasive alternative. This randomized controlled trial compares postoperative pain, patient satisfaction, and hospital stay between Laser Hemorrhoidoplasty and conventional hemorrhoidectomy in patients with Grade II and Grade III hemorrhoids.
Detailed description
This single-center randomized controlled trial was conducted in the Department of Surgery, Jinnah Hospital Lahore. Ninety-six patients diagnosed with Grade II or Grade III hemorrhoids were randomized into two equal groups. Group A underwent Laser Hemorrhoidoplasty. Group B underwent conventional Milligan Morgan Hemorrhoidectomy. Patients were followed postoperatively for pain assessment using the Visual Analogue Scale (VAS), hospital stay, and patient satisfaction using a structured Likert-scale questionnaire.
Interventions
PROCEDURELaser Hemorrhoidoplasty
Patients randomized to the intervention group underwent Laser Hemorrhoidoplasty under spinal anesthesia. A diode laser probe was introduced into the hemorrhoidal tissue through a small mucosal entry point under direct visualization using an anoscope. Controlled laser energy was delivered submucosally to achieve coagulation, shrinkage, and fixation of the hemorrhoidal cushions while preserving the surrounding anoderm and mucosa. The procedure was performed according to standard surgical protocols with the aim of reducing postoperative pain, bleeding, and recovery time.
PROCEDUREMilligan Morgan Hemorrhoidectomy
Patients randomized to the control group underwent conventional open Milligan Morgan Hemorrhoidectomy under spinal anesthesia. The hemorrhoidal pedicles were identified, ligated, and excised using standard surgical techniques. The wounds were left open with preservation of mucocutaneous bridges between excision sites. Hemostasis was achieved as required. Patients received routine postoperative care and follow-up according to institutional protocols.
Sponsors
Allama Iqbal Medical College
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Age ≥18 years Grade II hemorrhoids Grade III hemorrhoids Both genders
Exclusion criteria
Rectal prolapse Anal fissure Anorectal malignancy Pregnancy or lactating mothers
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Pain | Post Operative period: (6) Six Hourly in first 48 Hours, at 1 week post operative period & at 1 month post operatively. | Pain measured using Visual Analogue Scale (VAS). |
| Patient Satisfaction | 1 month postoperative | Patient satisfaction assessed using Likert-scale questionnaire. |
Countries
Pakistan
Outcome results
None listed