Comparison of “Mucopexy with Haemorrhoidal Artery Ligation with Open Hemorrhoidectomy in Terms of Effectiveness and Outcome

Mucopexy with Haemorrhoidal Artery Ligation with Open Hemorrhoidectomy

Authors

  • Muhammad Asad Department of General Surgery, Islamic International Medical College, Rawalpindi, Pakistan
  • Kiran Rehman Department of General Surgery, Islamic International Medical College, Rawalpindi, Pakistan
  • Muhammad Ismail Seerat Department of General Surgery, Islamic International Medical College, Rawalpindi, Pakistan
  • Maryam Iftikhar Department of General Surgery, Islamic International Medical College, Rawalpindi, Pakistan
  • Bilal Ahmed Department of General Surgery, Islamic International Medical College, Rawalpindi, Pakistan
  • Adil Hameed Department of General Surgery, Islamic International Medical College, Rawalpindi, Pakistan
  • Sufyan Rauf Department of General Surgery, Islamic International Medical College, Rawalpindi, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i2.2605

Keywords:

Hemorrhoids, Hemorrhoidectomy, Mucopexy, Haemorrhoidal Artery Ligation

Abstract

Traditional haemorrhoidectomy techniques are effective in the treatment of haemorrhoids but are associated with an increased risk of postoperative bleeding, pain, and longer recovery time. Our study on Mucopexy with haemorrhoidal artery ligation compares the outcomes in both procedures. Objective: To compare operating time, postoperative pain and bleeding, and postoperative urinary retention with both methods. Methods: This randomized control trial was conducted at the Department of General Surgery at the Pakistan Railway Hospital from January 2023 to December 2023. Results: In the hemorrhoidectomy group, the median age was 44.6 ± 14.54 years and the mean age of 50.91 ± 17.23 years for the other group. The mean operating time for the Hemorrhoidectomy group was 56.04 ± 7.52 minutes, while for the Mucopexy group, it was 40.36 ± 6.85 minutes. The difference was significant (p=0.000000000000000078). On the 1st day, the mean pain score (numerical rating scale for pain) for the Hemorrhoidectomy group was 7.00 ± 1.17, whereas for the Mucopexy group, it was 3.59 ± 1.15 with a significant difference (p=0.000000000000000578). On the 7th postoperative day, the mean score on the numerical rating scale for pain for the Hemorrhoidectomy group was 2.37 ± 1.10, as compared to the mucopexy group, which was 1.07 ± 0.25, (p=0.0000000000258). No statistically significant difference was found for Postoperative bleeding and urinary retention between the two groups. Conclusions: It was concluded that HAL with Mucopexy has shown significant improvement in postoperative pain and operating time as compared to the open haemorrhoidectomy.

References

Jalil MA, Hassan ME, Kobra K, Faruk MO, Aziz MM. Stapled and Open Haemorrhoidectomy; A Comparative Study of Early Outcome. Bangladesh Journal of Medical Science. 2022 Feb; 21(2): 438-43. doi: 10.3329/bjms.v21i2.58079.

Gallo G, Martellucci J, Sturiale AE, Clerico G, Milito G, Marino F et al. Consensus Statement of the Italian Society of Colorectal Surgery (SICCR): Management and Treatment of Hemorrhoidal Disease. Techniques in Coloproctology. 2020 Feb; 24: 145-64. doi: 10.1007/s10151-020-02149-1.

Gupta K. Minimal Invasive Procedures for Hemorrhoids. In Lasers in Proctology. Singapore: Springer Nature Singapore. 2022 Nov: 85-96. doi: 10.1007/978-981-19-5825-0_7.

Balciscueta Z, Balciscueta I, Uribe N. Post-Hemorrhoidectomy Pain: Can Surgeons Reduce It? A Systematic Review and Network Meta-Analysis of Randomized Trials. International Journal of Colorectal Disease. 2021 Dec; 36(12): 2553-66. doi: 10.1007/s00384-021-04013-6.

Van de Hoef D, Hogan A. Haemorrhoidal Artery Ligation Compared to Alternative Surgical Techniques for the Treatment of Grade II-IV Haemorrhoids: A Systematic Review. Journal of Mind and Medical Sciences. 2023; 10(1): 15-33. doi: 10.22543/2392-7674.1385.

Miyamoto H. Minimally Invasive Treatment for Advanced Hemorrhoids. Journal of the Anus, Rectum and Colon. 2023 Jan; 7(1): 8-16. doi: 10.23922/jarc.2022-068.

He F, Zhang X, Lu D, Wang Z. Clinical Efficacy of Ultrasound Doppler-Guided Hemorrhoidal Artery Ligation Combined with Procedure for Prolapse and Hemorrhoids in Treatment of Severe Hemorrhoids. Medicine. 2023 Nov; 102(47): e36189. doi: 10.1097/MD.0000000000036189.

Nagorni E, Nikolaou C, Mitsala A, Pappas-Gogos G, Oikonomou P, Tsalikidis C et al. Evaluation of Transanal Hemorrhoidal Dearterialisation (THD)-Mucopexy as A Successful Treatment for Stage IV Haemorrhoids: A Prospective, Observational Study and A Literature Review. Gastroenterology Review/Przegląd Gastroenterologiczny. 2024; 19(1). doi: 10.5114/pg.2024.139214.

Kazemi N, Mena J, Elzeftawy M. 352 Systematic Review and Meta-Analysis: Transanal Hemorrhoidal Dearterialization (THD) versus Milligan-Morgan Hemorrhoidectomy (MMH) in Grade III/IV Hemorrhoids. British Journal of Surgery. 2024 Jul; 111(Supplement_6): znae163-667. doi: 10.1093/bjs/znae163.667.

Alemrajabi M, Akbari A, Sohrabi S, Rezazadehkermani M, Moradi M, Agah S et al. Simple Mucopexy and Hemorrhoidal Arterial Ligation with and without Doppler Guide: A Randomized Clinical Trial for Short-Term Outcome. Annals of Coloproctology. 2022 May; 39(4): 351. doi: 10.3393/ac.2022.00017.0002.

Symeonidis D, Spyridakis M, Zacharoulis D, Tzovaras G, Samara AA, Valaroutsos A et al. Milligan–Morgan Hemorrhoidectomy Vs. Hemorrhoid Artery Ligation and Recto-Anal Repair: A Comparative Study. BioMed Central Surgery. 2022 Dec; 22(1): 416. doi: 10.1186/s12893-022-01861-z.

Sobrado CW, Sobrado LF, Nahas SC, Cecconello I. A New Approach for Hemorrhoid Disease: Selective Dearterialization and Mucopexy Without Doppler Guidance. ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo). 2021 May; 34(01): e1560. doi: 10.1590/0102-672020210001e1560.

Khalil MM, Deabes SM, Amer YA. Comparative Study between Doppler-Guided Haemorrhoidal Artery Ligation (HAL) and Conventional Haemorrhoidectomy for Treatment of III and IV Degree Haemorrhoids. The Egyptian Journal of Hospital Medicine. 2019 Apr; 75(6): 3113-8. doi: 10.21608/ejhm.2019.34253.

Rijal B and Basnet RB. A Prospective Randomized Controlled Trial Comparing the Immediate Post-Operative Complications Between Open and Semi-open Hemorrhoidectomy. Journal of Society of Surgeons of Nepal. 2019 Dec; 22(1): 18-22. doi: 10.3126/jssn.v22i1.28711.

Mohapatra R, Murmu D, Mohanty A. A Comparative Study of Open and Closed Hemorrhoidectomy. International Surgery Journal. 2018 May; 5(6): 2335-8. doi: 10.18203/2349-2902.isj20182249.

Chivate SD, Killedar MM, Ladukar LD, Vardhani GS, Kavathe SK, Kanekar SR. Transanal Suture Mucopexy for Hemorrhoids. Diseases of the Colon and Rectum. 2022 May; 65(5): 742-9. doi: 10.1097/DCR.0000000000002191.

Ferrandis C, De Faucal D, Fabreguette JM, Borie F. Efficacy of Doppler-Guided Hemorrhoidal Artery Ligation with Mucopexy, in the Short and Long Terms for Patients with Hemorrhoidal Disease. Techniques in Coloproctology. 2020 Feb; 24: 165-71. doi: 10.1007/s10151-019-02136-1.

Giuliani A, Romano L, Necozione S, Cofini V, Di Donato G, Schietroma M et al. Excisional Hemorrhoidectomy Versus Dearterialization with Mucopexy for the Treatment of Grade III Hemorrhoidal Disease: the EMODART3 multicenter study. Diseases of the Colon and Rectum. 2023 Dec; 66(12): e1254-63. doi: 10.1097/DCR.0000000000002885.

Xu L, Chen H, Lin G, Ge Q, Qi H, He X. Transanal Hemorrhoidal Dearterialization with Mucopexy Versus Open Hemorrhoidectomy in the Treatment of Hemorrhoids: A Meta-Analysis of Randomized Control Trials. Techniques in Coloproctology. 2016; 20(12): 825-833. doi: 10.1007/s10151-016-1551-2.

Karkalemis K, Chalkias PL, Kasouli A, Chatzaki E, Papanikolaou S, Dedemadi G. Safety and Effectiveness of Hemorrhoidal Artery Ligation Using the HAL-RAR Technique for Hemorrhoidal Disease. Langenbeck's Archives of Surgery. 2021 Nov;406(7):2489–95. doi: 10.1007/s00423-021-02190-0.

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Published

2025-02-28

How to Cite

Asad, M., Rehman, K., Seerat, M. I., Iftikhar, M., Ahmed, B., Hameed, A., & Rauf, S. (2025). Comparison of “Mucopexy with Haemorrhoidal Artery Ligation with Open Hemorrhoidectomy in Terms of Effectiveness and Outcome: Mucopexy with Haemorrhoidal Artery Ligation with Open Hemorrhoidectomy . Pakistan Journal of Health Sciences, 6(2), 191–195. https://doi.org/10.54393/pjhs.v6i2.2605

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