Background and Aim: This simple randomized study to evaluate the short term results of ligation anopexy 
technique in comparison to the traditional diathermy hemorrhoidectomy in management of advanced 
hemorrhoidal disease.
Patients and Methods: forty patients complaining of advanced hemorrhoidal disease (grade III and IV) were 
randomly assigned into two equal groups of twenty patients, Group A: underwent diathermy 
hemorrhoidectomy (DH), and Group B: underwent ligation anopexy (LA). Follow up for three months was 
done to evaluate the early and late complications and the symptoms control in both groups.
Results: the mean operative time was significantly shorter in patients treated with ligation anopexy, 
(P=0.008), and the hospital stay was longer in diathermy hemorrhoidectomy group (DH) but the difference 
was not significant. The intra operative blood loss was significantly less in ligation anopexy group (LA), 
(p=0.021). The post-operative pain in ligation anopexy group (LA) was significantly less than that in 
diathermy hemorrhoidectomy group (DH) with significantly shorter duration (p= 0.002)and the return to 
normal activity was significantly faster in ligation anopexy group, where the mean off-work time was 7.25 ± 
1.55 days while in diathermy hemorrhoidectomy group it was 10.40 ± 1.85 days, ( P=0.001). By the end of 
follow up period ther was no significant difference between the two groups regarding the symptoms control.
Conclusion: ligation anopexy is an easy, safe, and cheap, technique which has a comparable success rate with 
diathermy hemorrhoidectomy regarding the early symptoms control with less complications rate so it may
offers a good alternative to other treatment modalities of advanced hemorrhoidal disease.