[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100656502":3},{"organization":4,"outcomesModule":7,"designInfo":42,"detailedDescription":48,"studyPopulation":41,"armGroups":49,"interventions":62,"overallOfficials":41,"centralContacts":41,"locations":72,"responsibleParty":92,"collaborators":41,"id":96,"slug":97,"hasResults":98,"nctId":99,"briefTitle":100,"officialTitle":101,"acronym":41,"eligibilityCriteria":102,"healthyVolunteers":98,"sex":103,"minAge":104,"maxAge":41,"enrollmentInfo":105,"targetDuration":41,"studyType":108,"phases":109,"briefSummary":111,"conditions":112,"keywords":114,"overallStatus":75,"whyStopped":41,"lastUpdateSubmitDate":120,"lastUpdatePostDateStruct":121,"startDateStruct":124,"completionDateStruct":126,"leadSponsor":128,"locationsCount":129},{"fullName":5,"class":6},"Sohag University","OTHER",{"primaryOutcomes":8,"secondaryOutcomes":16,"otherOutcomes":41},[9,13],{"measure":10,"description":11,"timeFrame":12},"Postoperative Pain Score","Assessed using the Visual Analogue Scale (VAS) scored from 0 (no pain) to 10 (worst imaginable pain) at fixed postoperative intervals.","Up to 6 months post-surgery",{"measure":14,"description":15,"timeFrame":12},"Incidence of Postoperative Bleeding","Evaluation of early or delayed postoperative perianal bleeding requiring intervention or readmission.",[17,21,24,27,31,35,38],{"measure":18,"description":19,"timeFrame":20},"Operative Time","Duration in minutes from the initiation of tissue excision to complete surgical hemostasis.","Intraoperative (at time of surgery)",{"measure":22,"description":23,"timeFrame":20},"Intraoperative Blood Loss","Estimated intraoperative blood loss measured in milliliters.",{"measure":25,"description":26,"timeFrame":12},"Total Postoperative Analgesic Requirement","Total analgesic dosage, type, and duration required for postoperative pain management.",{"measure":28,"description":29,"timeFrame":30},"Time to Complete Wound Healing","Clinical assessment of complete re-epithelialization of the anal wounds documented in weeks\u002Fmonths.","Assessed at 1 week, 2 weeks, 1 month, 3 months, and 6 months",{"measure":32,"description":33,"timeFrame":34},"Length of Hospital Stay","Duration of postoperative stay in hours\u002Fdays from operation until fulfilling discharge criteria.","From surgical admission up to discharge (average 1-2 days)",{"measure":36,"description":37,"timeFrame":12},"Time to Return to Normal Activity","Recorded in days from surgery until the patient comfortably resumes routine daily non-strenuous activities.",{"measure":39,"description":40,"timeFrame":12},"Rate of Postoperative Complications and Recurrence","Incidence of urinary retention, wound infection, anal stenosis, continence disturbance, or symptom recurrence.",null,{"allocation":43,"interventionModel":44,"interventionModelDescription":41,"primaryPurpose":45,"observationalModel":41,"timePerspective":41,"maskingInfo":46},"RANDOMIZED","PARALLEL","TREATMENT",{"masking":47,"maskingDescription":41,"whoMasked":41},"NONE","Symptomatic advanced hemorrhoids (grades III-IV) frequently require excisional surgical intervention. Traditional ligation techniques involve pedicle transfixion that often exacerbates postoperative pain, anal spasms, and urinary retention. Energy-based vessel sealing systems provide reliable pedicle occlusion without conventional transfixion or suture ligation, potentially expediting operative time and recovery. In this prospective randomized study conducted at the Department of General Surgery, Sohag University Hospital, 50 eligible adult patients with symptomatic grade III-IV hemorrhoidal disease will be randomly allocated (1:1) into two equal groups: Group A (n=25): Sutureless hemorrhoidectomy using an energy-based vessel sealing device. Group B (n=25): Conventional ligation hemorrhoidectomy using the standard Milligan-Morgan technique. Postoperatively, patients receive standardized analgesia and care, with systematic follow-up at 1 week, 2 weeks, 1 month, 3 months, and 6 months to evaluate pain scores, bleeding, wound healing, complication rates, return to normal activity, and symptom recurrence.",[50,56],{"label":51,"type":52,"description":53,"interventionNames":54},"Conventional Ligation Hemorrhoidectomy Group","ACTIVE_COMPARATOR","Patients undergoing conventional excisional hemorrhoidectomy using the Milligan-Morgan technique with suture ligation of the vascular pedicle.",[55],"Procedure: Conventional Milligan-Morgan hemorrhoidectomy",{"label":57,"type":58,"description":59,"interventionNames":60},"Sutureless Hemorrhoidectomy Group","EXPERIMENTAL","Patients undergoing sutureless excisional hemorrhoidectomy using an energy-based vessel sealing device (LigaSure or Harmonic Scalpel) without conventional pedicle transfixion or suture ligation.",[61],"Procedure: Energy-based sutureless hemorrhoidectomy",[63,68],{"type":64,"name":65,"description":66,"armGroupLabels":67,"otherNames":41},"PROCEDURE","Energy-based sutureless hemorrhoidectomy","Excision of hemorrhoidal columns with vessel pedicle sealing using an energy-based device (LigaSure or Harmonic Scalpel) without conventional pedicle transfixion or suture ligation.",[57],{"type":64,"name":69,"description":70,"armGroupLabels":71,"otherNames":41},"Conventional Milligan-Morgan hemorrhoidectomy","Standard Milligan-Morgan hemorrhoidectomy with surgical dissection of hemorrhoidal columns and absorbable suture transfixion and ligation of vascular pedicles.",[51],[73],{"facility":74,"status":75,"city":76,"state":41,"zip":77,"country":78,"countryCode":79,"cosmosGeoPoint":80,"geoPoint":85,"contacts":86},"Sohag University Hospital, Department of General Surgery","RECRUITING","Sohag","82749","Egypt","EG",{"type":81,"coordinates":82},"Point",[83,84],31.69478,26.55695,{"lat":84,"lon":83},[87],{"name":88,"role":89,"phone":90,"phoneExt":41,"email":91},"Kerolos Mohareb Abdelmalak, MBBCh","CONTACT","01282319310","moharebkero74@gmail.com",{"type":93,"investigatorFullName":94,"investigatorTitle":95,"investigatorAffiliation":5,"oldNameTitle":41,"oldOrganization":41},"PRINCIPAL_INVESTIGATOR","Keroless Mohareb Abdelmalak","Resident of General Surgery, Oncological and Laparoscopic Surgery","100656502","sutureless-hemorrhoidectomy-versus-conventional-ligation-in-advanced-hemorrhoids-100656502",false,"NCT07824999","Sutureless Hemorrhoidectomy Versus Conventional Ligation in Advanced Hemorrhoids","Sutureless Hemorrhoidectomy Versus Conventional Ligation: A Comparative Prospective Randomized Clinical Trial","Inclusion Criteria:\n\n* Adult patients aged 18 years or older.\n* Patients with symptomatic grade III or grade IV hemorrhoidal disease.\n* Combined internal and external hemorrhoidal disease requiring excisional hemorrhoidectomy.\n* Recurrent bleeding, prolapse, pain, mucous discharge, or hygiene difficulty despite conservative or office-based treatment.\n\nExclusion Criteria:\n\n* Patients younger than 18 years.\n* Grade I or grade II hemorrhoids suitable for conservative or office-based therapy.\n* Acute thrombosed external hemorrhoids requiring emergency management.\n* Associated anal fissure, fistula-in-ano, perianal abscess, or inflammatory bowel disease.\n* Suspected or confirmed colorectal malignancy\\[cite: 1\\].\n* History of previous anorectal surgery\\[cite: 1\\].\n* Bleeding diathesis, uncontrolled anticoagulant therapy, or severe coagulopathy\\[cite: 1\\].","ALL","18 Years",{"count":106,"type":107},50,"ESTIMATED","INTERVENTIONAL",[110],"NA","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.",[113],"Hemorrhoids",[115,116,117,118,119],"Sutureless hemorrhoidectomy","LigaSure","Harmonic Scalpel","Milligan-Morgan","Postoperative pain","2026-09-13",{"date":122,"type":123},"2026-09-17","ACTUAL",{"date":125,"type":107},"2026-10-01",{"date":127,"type":107},"2027-10-01",{"name":5,"class":6},1]