Stapled haemorrhoidectomy versus openhaemorrhoidectomy: a prospective comparative study

Bhandari, Rita; Lakhey, P.J.; Singh, Yogendra; Mishra, Parashuram; Kp, Singh

doi:10.3126/jcmc.v4i4.11956

Cited by 2 publications

(2 citation statements)

References 13 publications

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“…External hemorrhoids, third and fourth degree of internal hemorrhoids, and symptoms alleviation rubber band ligation failure should be treated with surgical hemorrhoidectomy [8]. The Fergusson hemorrhoidectomy included anal mucosa complete closure with continuous absorbable suture through hemostasis and hemorrhoidal tissue [9]. Milligan-Morgan open hemorrhoidectomy is utilized in cases where a completely closed wound is not required due to gangrenous hemorrhoids or circumferential presence.…”

Section: Introductionmentioning

confidence: 99%

“…The pedicle ligation is the end of the procedure. Below the dentate line, the sensitive anoderm incorporates severe postoperative pains in both open and closed hemorrhoidectomy [10]. Infrared photocoagulation, Milligan Morgan, Regularization of bowel function, Stapled hemorrhoidectomy, and Sclerotherapy are different treatment modalities for hemorrhoids.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Milligan Morgan Versus Stapled Hemorrhoidectomy in Patients Attending Tertiary Care Hospital

Ghafoor¹,

Haider²,

Kauser³

et al. 2022

PJMHS

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Background and Aim: Hemorrhoids are common anorectal problems that cause fear by bleeding, pruritus burden, and thrombosis pain. Prolapse and hemorrhoids are managed by stapled hemorrhoidectomy (SH). Initially, Stapled hemorrhoidectomy seemed to be a good alternative for Milligan Morgan (MM) hemorrhoidectomy verified by various studies. However, recent studies found that long-term assessment of stapled hemorrhoidectomy gives poor outcomes in terms of postoperative complications and patient’s satisfaction. Therefore, the present study aimed to compare the Milligan Morgan versus stapled Hemorrhoidectomy in patients attending Tertiary Care Hospital. Methodology: This prospective study was carried out on 120 patients at the Department of Surgery Unit-I Sheikh Zayed Medical College Rahim Yar Khan from 1st May 2021 to 31th April 2022. All the patients of either gender with an age range from 18 years to 60 years after 2nd degree hemorrhoids failure of multiple rubber band ligations and 3rd and 4th degree hemorrhoids were enrolled. Concomitant anal disease patients such as ano-rectal cancer, fissure, fistula, and abscess were excluded. Patients were divided into two categories: Group-I Stapled Hemorrhoidectomy and Group-II Milligan Morgan. Post-operative complications such as stenosis and urinary retention during hospitalization were recorded. All the data were entered and analyzed using SPSS version 25. Results: The overall mean age of Group-I and Group-II was 46.78±12.66 years and 48.91±14.82 years respectively. Each group comprised 60 patients. Out of the SH group, 35 (58.3%) were males and 25 (41.7%) were females. Of the MM Group-II, male and females were 44 (73.3%) and 16 (26.7%) respectively. About 53 (88.3%) patients in Group-I and 32 (53.3%) patients in Group-II had relief from bleeding and other symptoms. The surgical duration in Group-I and Group-II was 22.9 ± 12.9 minutes and 34.8 ± 9 minutes with statistical significance (p=0.000) respectively. The vessel spurting ligation and postoperative hemorrhage was developed in 5 (8.3%) in SH group patients. Post-operative bleeding and intervention was found in 26 (43.3%) patients in Group-II. The prevalence of postoperative pain requiring analgesia was found in 20 (33.3%) in Group-I and34 (56.7%) in Group-II respectively. After treatment, fecal incontinence was developed in none of the patients in both groups. The postoperative complications such as anal tag, tenderness, bleeding, urinary retention, and wound discharge were higher in Group-II as compared to Group-I with statistical insignificance (p< 0.05). Conclusion: The present study found that hemorrhoids could be effectively treated by Stapled hemorrhoidectomy compared to Milligan-Morgan procedure in terms of postoperative pain, hospital stay, and usage of analgesics, reduced postoperative complications, patient’s satisfaction, and time taken for operation. Beside lesser complications, fecal incontinent, severe pain, and other complications could result from stapling technique. Post-operative pain and complete pain relief was significantly lower in MM group. Hospitalization in the SH group was shorter than the MM group. Hemorrhoid recurrence was null in both SH and MM group. Keywords: Hemorrhoid Surgery, Stapled Hemorrhoidectomy, Milligan-Morgan

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of Milligan Morgan Versus Stapled Hemorrhoidectomy in Patients Attending Tertiary Care Hospital

Ghafoor¹,

Haider²,

Kauser³

et al. 2022

PJMHS

View full text Add to dashboard Cite

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Comparative study between stapled and open hemorrhoidectomy results with one-year follow-up

Salama,

Hossainy,

Rihan

2023

The Egyptian Journal of Surgery

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Background Hemorrhoids are one of the most prevalent diseases of mankind, affecting 4%–36% of the general population. Most patients are asymptomatic. Anal bleeding during the act of defecation is the most common presenting symptom. Many techniques were described for treatment, including stapled hemorrhoidectomy and conventional (open) ones. Objective The objective is to compare the effectiveness, short-term outcomes, and postoperative complications of stapled hemorrhoidopexy against open hemorrhoidectomy in the treatment of symptomatic primary piles. Methods A total of 76 patients were operated on at Al-Azhar University Hospital. They were divided into two equal groups: the stapled group (operated using a proximate PPH hemorrhoidal stapler of 33 mm) and the open group. All patients were followed for 1 year. Preoperative complaints, operative time and blood loss, postoperative pain, complications, and resumption of daily activities were recorded for both groups. Results Intraoperative blood loss and duration of operation were less in the stapler group. Postoperative bleeding, postoperative pain, and discomfort were less in the stapler group, with a significant difference from the open group. Healing and resumption of daily activities were faster in the stapler group. Regarding early recurrence, it happened in two cases in the stapler group and in the open group as well. There are no differences between both groups regarding urine retention. Anal incontinence did not happen in both groups. Mild anal stenosis occurred in one case in every group and occurred late. Conclusion Stapled hemorrhoidectomy is a promising procedure with less pain, a shorter duration of hospital stay, and a faster resumption of daily activity than open hemorrhoidectomy. However, long-term follow-up for many years is still needed to define the recurrence rate in stapled hemorrhoidectomy.

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Stapled haemorrhoidectomy versus openhaemorrhoidectomy: a prospective comparative study

Cited by 2 publications

References 13 publications

Comparison of Milligan Morgan Versus Stapled Hemorrhoidectomy in Patients Attending Tertiary Care Hospital

Comparison of Milligan Morgan Versus Stapled Hemorrhoidectomy in Patients Attending Tertiary Care Hospital

Comparative study between stapled and open hemorrhoidectomy results with one-year follow-up

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