Surgical Outcomes of Ligation and Excision of Hemorrhoids

Background: Ligation and excision (LE) is a highly versatile procedure applicable to all forms of internal and external hemorrhoids as well as hemorrhoids with concomitant lesions. Hence, LE is an essential surgical technique that proctologists should learn. However, compared with other surgical techniques, this procedure has several disadvantages, such as complications (e.g., pain, bleeding, and stenosis) and longer learning time.Objective and methods: Among 558 patients who underwent LE at more than three sites at our hospital between December 2015 and March 2022, 368 who had received anorectal manometry before and after the surgery were included in the study. Postoperative outcomes and complications were evaluated.Surgical outcomes: Overall, 134 men and 234 women with a median age of 49.5 years were included. The median duration of surgery was 23 min. The maximum anal canal resting pressure decreased by 17.6% and 13.6% after surgery in men and women, respectively. Postoperative complications comprised 4.3% bleeding, 2.2% stenosis, and 1.6% urinary incontinence.Conclusion: The incidence of postoperative complications here was in line with the results of previous studies. LE is a highly radical surgical technique; however, surgeons should be wary of a decrease in sphincter function.