| Abstrakt: |
Background:Hemorrhoids a very common anorectal diseases that affected both genders at any age with a peak incidence ~ 45 and 65 years. There are different hemorrhoids treatment modalities ranging from conservative approach for 1st and 2nd, whereas 3rd and 4th degree usually require surgical intervention like; milligan-morgan hemorrhoidectomy (MMH) and laser hemorrhoidoplasty (LHP). The current study aimed to assess efficacy and postoperative outcomes of MMH comparing with LHP in patients with 3rd degree hemorrhoids. Patients and methods: Our prospective comparative clinical study was carried out on 30 patients with 3rd degree hemorrhoids intending for treatment. Fifteen patients underwent a standardized MMH technique, (group I), and the other 15 operated upon with LHP (group II), using diode laser of 980 nm (Lasotronix). Postoperative pain was assessed using a visual analog scale (VAS) at 7, 14, 28, 42 and 180 days post-operation. Operative time, hospital stay, and postoperative bleeding were also assessed. Results: There was a statistically significant difference between the 2 groups regarding operative time, hospital stay and postoperative pain (p value < 0.001), with less time taken for the LHP group 14.60 ± 3.13 versus 29.53 ± 4.05 minutes in MMH group. The mean VAS score of 9.53 ± 0.51 in group I vs 5.9 3 ± 0.79 in LHP group, 1 day postoperation, with a significant improvement in LHP group at follow up days (~ 0 VAS score). Regard bleeding and infection, there was no significant difference was found between 2 groups. Conclusion: Taken together, our outcomes endorse our assumption that, although open MMH technique is the mainstays for 3rd degree hemorrhoids management, LHP is an innovative, effective, and could be a promising alternative with a good patient acceptance and postoperative outcome improvement. [ABSTRACT FROM AUTHOR] |
