Comparative analysis of Ferguson hemorrhoidectomy combined with doppler-guided hemorrhoidal artery ligation and Ferguson hemorrhoidectomy in hemorrhoidal disease treatment.

Abstract

Background: In hemorrhoidal disease, despite the existence of numerous treatment options to alleviate symptoms, surgical intervention continues to be the gold standard. The advantages and disadvantages of many methods have been shown in numerous studies However, only a few studies have compared the effectiveness of combined methods.

Aim: To compare the results of a coloproctology clinic that switched to the Doppler-guided hemorrhoidal artery ligation (DG-HAL) + Ferguson hemorrhoidectomy (FH) technique from the FH in the treatment of hemorrhoidal disease.

Methods: In this retrospective cohort, data from a total of 45 patients who underwent DG-HAL + FH (n = 24) and FH (n = 21) for grade III hemorrhoidal disease between 2020 and 2022 were analyzed. Demographic and clinical data, surgical duration, intraoperative blood loss, hospital stay, postoperative analgesic consumption, pain scores using the Visual Analog Scale (VAS), complications, time to return to normal activities, and the recurrence rate were compared in both groups.

Results: The study included 45 patients, with 75.6% (n = 34) male and 24.4% (n = 11) female. The rate of intraoperative blood loss was higher in the FH group (P < 0.05). The VAS scores and postoperative complication rates were similar in both groups. The need for postoperative analgesics was lower in the DG-HAL + FH group (2 vs 4 days, P < 0.05), while the FH group showed a shorter time to return to normal activities (9.5 vs 6.0 days, P = 0.02). The recurrence rate (16.7% vs 0%) and Clavien-Dindo Score-1 complications (20.8% vs 9.5%, P = 0.29) were higher in the DG-HAL + FH group but were insignificant.

Conclusion: Our study revealed that the addition of the DG-HAL to classical hemorrhoidectomy caused less intraoperative bleeding and a lower postoperative analgesia requirement.