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RECRUITING Not applicable ClinicalTrials.gov

Sutureless Hemorrhoidectomy Versus Conventional Ligation in Advanced Hemorrhoids

Sponsor: Sohag University • ClinicalTrials.gov ID: NCT07824999

Registry updated: 2026-09-17
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Description

Hemorrhoidal disease is a frequent benign anorectal ailment in surgical practice. Conventional excisional hemorrhoidectomy using the Milligan-Morgan technique remains effective but is significantly limited by severe postoperative pain and related complications. Sutureless hemorrhoidectomy utilizing energy-based vessel sealing devices (such as LigaSure or Harmonic Scalpel) aims to minimize tissue trauma, blood loss, and postoperative discomfort. This prospective comparative randomized clinical trial aims to evaluate and compare the perioperative and postoperative outcomes of sutureless hemorrhoidectomy versus conventional ligation hemorrhoidectomy in adult patients with advanced (grades III and IV) hemorrhoidal disease.

Interventions

  • Energy-based sutureless hemorrhoidectomy (Procedure)
    Excision of hemorrhoidal columns with vessel pedicle sealing using an energy-based device (LigaSure or Harmonic Scalpel) without conventional pedicle transfixion or suture ligation.
  • Conventional Milligan-Morgan hemorrhoidectomy (Procedure)
    Standard Milligan-Morgan hemorrhoidectomy with surgical dissection of hemorrhoidal columns and absorbable suture transfixion and ligation of vascular pedicles.

Eligibility criteria

Inclusion Criteria: * Adult patients aged 18 years or older. * Patients with symptomatic grade III or grade IV hemorrhoidal disease. * Combined internal and external hemorrhoidal disease requiring excisional hemorrhoidectomy. * Recurrent bleeding, prolapse, pain, mucous discharge, or hygiene difficulty despite conservative or office-based treatment. Exclusion Criteria: * Patients younger than 18 years. * Grade I or grade II hemorrhoids suitable for conservative or office-based therapy. * Acute thrombosed external hemorrhoids requiring emergency management. * Associated anal fissure, fistula-in-ano, perianal abscess, or inflammatory bowel disease. * Suspected or confirmed colorectal malignancy\[cite: 1\]. * History of previous anorectal surgery\[cite: 1\]. * Bleeding diathesis, uncontrolled anticoagulant therapy, or severe coagulopathy\[cite: 1\].

Conditions

Hemorrhoids

Locations

  • Sohag University Hospital, Department of General Surgery — Sohag, Egypt
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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

View Official Record