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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Laser Hemorrhoidoplasty | Experimental | Patients underwent Laser Hemorrhoidoplasty using diode laser energy applied to hemorrhoidal tissue. |
|
| Milligan Morgan Hemorrhoidectomy | Active Comparator | Patients underwent conventional open Milligan Morgan Hemorrhoidectomy. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Laser Hemorrhoidoplasty | Procedure | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative Pain | Pain measured using Visual Analogue Scale (VAS). | Post Operative period: (6) Six Hourly in first 48 Hours, at 1 week post operative period & at 1 month post operatively. |
| Patient Satisfaction | Patient satisfaction assessed using Likert-scale questionnaire. | 1 month postoperative |
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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
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Jinnah Hospital, Lahore. | Lahore | Punjab Province | Pakistan |
Individual participant data collected during the study will not be made publicly available. Data will remain confidential and will be retained by the investigators in accordance with institutional policies and ethical approval requirements.
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|
| Milligan Morgan Hemorrhoidectomy | Procedure | 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. |
|
| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| D017060 | Patient Satisfaction |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D000074822 | Treatment Adherence and Compliance |
| D015438 | Health Behavior |
| D001519 | Behavior |
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