Comparision of Ligasure hemorrhoidectomy and conservative treatment for thrombosed external hemorrhoids (TEH) in pregnancy

Abstract

Background: Ligasure hemorrhoidectomy for thrombosed external hemorrhoids in pregnancy has been rarely studied. Objective: The purpose of this article is to study the efficacy and safety of Ligasure hemorrhoidectomy comparing with conservative treatment for thrombosed external hemorrhoids in pregnancy. Design: This was a retrospective cohort study. Setting: The patients were treated at a tertiary referral center in China. Patients: 94 pregnant patients hospitalized for thrombosed external hemorrhoids from September 2020 to December 2021. Interventions: Ligasure hemorrhoidectomy treatment or conservative treatment according to the patient’s wishes. Main outcome measures: Symptom relief, recurrence and satisfaction of thrombosed external hemorrhoids in pregnancy with different interventions. Results: There were no differences between groups in maternal age, gestational age, body mass index, parity, constipation and a prior history of thrombosed external hemorrhoids. The pain scores were less in surgical group than in conservative group in post-treatment days 1 and 7. Time to return to normal activities was shorter in surgical group than in conservative group (6.51 vs. 13.52 days, P < 0.001). Post-treatment complications were mild in surgical group and there were no significant differences concerning the rate of abortion, preterm birth, cesarean delivery and weight of fetus. Recurrence rate was significantly lower in surgical group (8.57% vs. 30.43%, P = 0.017). The patient satisfaction scores were significantly higher in surgical group than in conservative group (Z = − 2.979, P = 0.003). Limitations: This was a retrospective study with a limited number of patients, the data was obtained from only one center. Conclusions: Comparing with conservative treatment, Ligasure hemorrhoidectomy for TEH in pregnancy results in more rapid pain relief, shorter time to return to normal activities, lower incidence of recurrence, and better patient satisfaction. This type of surgery has low and mild postoperative complications, is not attended by any risk to the mother or her fetus.