WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

*Mushtaq Talib Meesha Kaseel Aljadri, Muayad Jasim Daham, Haider Saad Judi and Bashar A. Abdulhassan

ABSTRACT

Background: Symptomatic hemorrhoids are a common anorectal condition affecting individuals across variousage groups and both genders. Multiple surgical techniques have been developed to manage this condition, withcontinual modifications aiming to reduce complications, particularly postoperative bleeding and pain. Aim: Thisstudy aimed to compare the clinical outcomes of the conventional Milligan-Morgan hemorrhoidectomy (MMH)with a modified technique—ligation first Milligan-Morgan hemorrhoidectomy (LF-MMH). Patients andMethods: A randomized comparative study was conducted on 136 patients diagnosed with symptomatichemorrhoids. Patients were randomly allocated into two groups: Group A (66 patients) underwent conventionalMMH, while Group B (70 patients) received LF-MMH. All patients were followed up for one weekpostoperatively to assess outcomes and complications. Results: The mean age of the patients was 37.5 years, with84 males and 52 females; no significant gender-related differences were observed between groups. The type ofanesthesia used showed no statistical significance. The operative time for LF-MMH was significantly shorter (15minutes) compared to conventional MMH (18 minutes). Intraoperative blood loss was also significantly reducedin Group B (30 ml) compared to Group A (50 ml). Two cases in Group A required postoperative repacking due tobleeding, whereas no such cases occurred in Group B, although this difference was not statistically significant. Nocases of anal stenosis were reported in either group. Conclusion: LF-MMH offers superior vascular control,leading to reduced intraoperative blood loss, fewer postoperative complications, and potentially lower analgesicrequirements. This technique may represent a safer and more effective alternative for hemorrhoid surgery.