title: Comparison of two procedures for symptomatic hemorrhoidal disease: Ligation under Vision and Ferguson Hemorrhoidectomy - a retrospective cohort study.
abstract: OBJECTIVE
  To compare Ligation under Vision (LUV) with Ferguson Hemorrhoidectomy (FH) in patients with Grade II, III and IV hemorrhoidal diseases according to their postoperative outcomes.
  
  
  METHODS
  Between July 2008 and August 2014, 155 patients underwent FH and 120 patients LUV, in Sakarya University Teaching and Research Hospital. Our retrospective analysis focuses on postoperative complications, postoperative pain and rate of recurrence. In LUV procedure, submucosal tissue of the hemorrhoidal pile base was transfixed using absorbable sutures under direct vision through anoscope in the Jackknife position.
  
  
  RESULTS
  In a mean postoperative follow-up period of 51.76+/-22.3 months; ectropion, anal fissure, and anal incontinence were the most frequent complications. The overall complication rate was significantly less after LUV than FH, (6.7%vs. 14.2%,P=0.047). The complication rate and need for a second or third surgery did not significantly differ between the two procedures with the increase in affected quadrants (P>0.05). The visual analog scale (VAS) at 24 hours was similar in both groups (P=0.267).
  
  
  CONCLUSIONS
  LUV is a safe, and practical procedure with similar outcomes compared to FH. LUV may be a better choice than excisional hemorrhoidectomies when three or four quadrants of the anal canal are involved with hemorrhoids as this reduces mucosal defect related possible complications such as ectropion and anal stenosis.
authors.affiliation: Dr. Hakan Demir, Department of General Surgery, Sakarya University Teaching and Research Hospital, Sakarya, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Demir
authors.affiliation: Kerem Karaman, Associate Professor, Department of General Surgery, Sakarya University Teaching and Research Hospital, Sakarya, Turkey.
authors.forename: Kerem
authors.initials: K
authors.lastname: Karaman
authors.affiliation: Metin Ercan, Associate Professor, Department of General Surgery, Sakarya University Teaching and Research Hospital, Sakarya, Turkey.
authors.forename: Metin
authors.initials: M
authors.lastname: Ercan
authors.affiliation: Prof. Havva Belma Kocer, Department of General Surgery, Sakarya University Teaching and Research Hospital, Sakarya, Turkey.
authors.forename: Havva Belma
authors.initials: HB
authors.lastname: Kocer
authors.affiliation: Prof. Fehmi Celebi, Department of General Surgery, Sakarya University Teaching and Research Hospital, Sakarya, Turkey.
authors.forename: Fehmi
authors.initials: F
authors.lastname: Celebi
keywords: Doppler transducer; Hemorrhoid; Ligation under vision; Transanal hemorrhoidal dearterialization