Article Type

Original Study


Objective The aim of this study was to compare the preliminary results of traditional transfixion excision versus ligation anopexy in the management of advanced (grades III and IV) hemorrhoidal disease with respect to postoperative pain, bleeding, and short-term follow-up complications. Background Ligation anopexy of hemorrhoids is a simple, cost-effective, and convenient modality for treating grade III hemorrhoids. Patients and methods We carried out a prospective, controlled, randomized study including 40 patients with hemorrhoidal disease grades III and IV. The participants were divided into two groups: group I was treated by classical transfixion excision hemorrhoidectomy, and group II was treated by ligation anopexy. Detailed history of all participants was obtained. Effectiveness, safety, postoperative complications, operative time, length of hospital stay, and time off work were evaluated. Results There was no significant difference between groups regarding age, sex, and preoperative symptoms. The duration of surgery was significantly shorter in patients treated with ligation anopexy (P < 0.001). Intraoperative bleeding was significantly decreased in patients treated with ligation anopexy. The postoperative pain score in the ligation anopexy group was significantly lower than that in group I at 24, 48, 72 h, and the second week postoperatively. Time off work in patients treated with ligation anopexy was significantly shorter compared with transfixion excision hemorrhoidectomy. Conclusion Ligation anopexy for prolapsing hemorrhoids is simple and safe with less postoperative bleeding, minimal analgesic requirement, no external wound problems, lower postoperative complications, and earlier return to normal activities.