COMPARATIVE STUDY OF LASER HAEMORRHOIDECTOMY VS MILIGAN MORGAN HAEMORRHOIDECTOMY FOR MANAGEMENT OF HEMORRHOIDS OF GRADE II & III

Abstract

Background: Hemorrhoidal disease is a common anorectal disease which can cause a substantial reduction in the quality of life when symptoms remain uncontrolled despite conservative treatments. Milligan-Morgan hemorrhoidectomy is still a proven surgical approach, especially in the event of prolapsing hemorrhoids, but it carries with it the disadvantages of postoperative pain and slow recovery. Laser hemorrhoidoplasty has become a minimally invasive option and may have some benefits in terms of peri-operative morbidity.

Objective: To compare the outcome of Laser hemorrhoidectomy versus Milligan Morgan hemorrhoidectomy for management of hemorrhoids of grade 2 and 3.

Methods: This was a Randomized controlled trial that was carried out at the Department of Surgery, Services Hospital Lahore, from April 2025 to August 2025. The patients were randomly divided into two groups: 60 with grade 2 or 3 hemorrhoids underwent laser hemorrhoidectomy and the other 60 underwent Milligan-Morgan hemorrhoidectomy. The operating time, intraoperative bleeding, post-operative pain based on the Visual Analogue Scale and hospital stay were documented. Independent samples t-test was performed to compare outcomes and a p ≤ 0.05 was considered statistically significant.

 Results: The laser group had significantly shorter operative time (16.2 ± 4.1 vs 26.5 ± 5.2 minutes), lower blood loss (4.8 ± 2.1 vs 22.4 ± 6.3 mL), lower postoperative pain scores (3.2 ± 0.9 vs 6.8 ± 1.2), and shorter hospital stay (0.8 ± 0.3 vs 1.4 ± 0.4 days), respectively (p < 0.001 for all).

Conclusion: Laser hemorrhoidectomy showed superior short term perioperative results compared to Milligan-Morgan hemorrhoidectomy, especially in terms of hospital stay, pain score and operative efficiency, and blood loss.