Comparitive study between laser hemorrhoidoplasty and conventional open surgical hemorrhoidectomy (Milligan Morgan technique) in 2nd & 3rd degree piles

Background: In contrast to the gold standard surgical treatment , conventional haemorrhoidectomy, a variety of minimally invasive surgical techniques have been developed over the past few decades for the management of grade II and III hemorrhoidal disease (HD).Objective: to evaluate the effectiveness of laser hemorrhoidoplasty (LHP) vs Milligan-Morgan hemorrhoidectomy (MMH) for the treatment of symptomatic second and third degree piles.Patients and Methods: This research was carried out at the University Hospital of Ain Shams. We recruited forty patients with grade II and III HD; twenty underwent open conventional (Milligan Morgan) hemorrhoidectomy (group A); the remaining twenty underwent laser hemorrhoidoplasty (group B). Evaluation of late postoperative problems, such as stenosis, incontinence, fistula, and recurrence of symptoms, and early postoperative complications, such as operational time, intraoperative blood loss, postoperative discomfort, usage of analgesics, postoperative bleeding, and postoperative discharge.Results: Postoperative pain was significantly lower in LHP than MMH group (P < 0.001). The operative time and intra-operative blood loss, hospital stay and post-operative analgesics requirements was less in LHP group (P < 0.001). Postoperative bleeding, urinary retention, anal stenosis and recurrence rate were seen with no statistical difference in both groups.Conclusion: When compared to the traditional Milligan-Morgan technique, laparoscopic hemorrhoidectomy (LHP) is a good technique for managing primary hemorrhoids of the second and third degree. It has a shorter operative duration, less postoperative pain, a shorter hospital stay, and less intraoperative blood loss. It also shows no significant difference in terms of postoperative bleeding, urinary retention, stenosis, and recurrence rate.