Article

Stapled haemorrhoidectomy compared with Milligan-Morgan excision for the treatment of prolapsing haemorrhoids: a prospective study.

4th Surgical Department of Aristotle University of Thessaloniki, Greece.
The European Journal of Surgery 02/2002; 168(11):621-5. pp.621-5
Source: PubMed

ABSTRACT To compare stapled haemorrhoidectomy with Milligan-Morgan haemorrhoidectomy.
Prospective open study.
Teaching hospital, Greece.
85 patients with prolapsing haemorrhoids were invited to choose between stapled and Milligan-Morgan haemorrhoidectomy. 48 chose the former and 37 the latter.
Operation. Postoperatively, the patients were given analgesics on demand, and were discharged as soon as their condition and particularly their pain had improved.
Patients' symptoms and their opinion about the procedures, which were recorded during their follow-up which lasted for 6 months.
Stapling resulted in a significantly shorter operating time, and less postoperative pain and other symptoms, than Milligan-Morgan excision (p < 0.001). Postoperative complications, and mean time in hospital did not differ significantly between the two groups. During the follow-up period there was no significant difference in the incidence of recurrences between the two groups. Six months after the operation, significantly more patients in the stapled group had residual skin tags-external haemorrhoids than in the Milligan-Morgan group, and all these patients had fourth degree haemorrhoids.
Stapled haemorrhoidectomy is a promising method of treatment for prolapsing third degree haemorrhoids. Its effectiveness is questionable for fourth degree ones. Initially, the results are as good as after Milligan-Morgan haemorrhoidectomy, especially for third degree haemorrhoids. However, more patients and longer follow-up periods are required for its long-term efficacy to be confirmed.

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Keywords

6 months
 
85 patients
 
analgesics
 
follow-up period
 
follow-up periods
 
fourth degree ones
 
long-term efficacy
 
Milligan-Morgan excision
 
Milligan-Morgan group
 
Milligan-Morgan haemorrhoidectomy
 
Patients' symptoms
 
postoperative pain
 
prolapsing third degree haemorrhoids
 
promising method
 
Prospective open study
 
stapled group
 
Stapled haemorrhoidectomy
 
Teaching hospital
 
third degree haemorrhoids
 
two groups