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Outcome of stapled haemorrhoidectomy versus Milligan Morgan's haemorrhoidectomy.
J Coll Physicians Surg Pak. 2009 Sep; 19(9):561-5.JC

Abstract

OBJECTIVE

To compare the postoperative outcome of stapled haemorrhoidectomy and conventional Milligan Morgan's open haemorrhoidectomy.

STUDY DESIGN

Comparative study.

PLACE AND DURATION OF STUDY

Surgical Unit 1, Ward-3, Department of Surgery, Jinnah Postgraduate Medical Centre, Karachi, from March to September 2006.

METHODOLOGY

Sixty patients of late 2nd, 3rd and 4th degree haemorrhoids were selected for admission from the outpatient department after taking informed consent. Patients with concomitant anal disease (e.g. fissure, abscess, fistula, ano-rectal cancer etc.) were excluded. Two groups of thirty each were made, one for Milligan-Morgan open haemorrhoidectomy and another for stapled haemorrhoidectomy, in which excision of a ring of mucosa proximal to the haemorrhoid(s) was done thus, interrupting the blood supply but maintaining continuity of the rectal mucosa. The operative time was measured in minutes. Postoperative pain was assessed through VAS. Bleeding was measured as no, mild, profuse. Other post-operative complications during hospital stay like urinary retention, anal stenosis etc. were noted. Student t-test, chi-square test and repeated measured analysis of variance were applied to compare the variables.

RESULTS

The mean age was 40.7+/-11.6 years. A majority (53.3%) of patients (combined % in both groups) had third degree haemorrhoid. The mean length of operative time was found statistically insignificant between open and stapled groups (19.6+/-5.9 vs. 22.4+/-7.2 minutes, p=0.974). However, the mean length of postoperative hospital stay was significantly less in the stapled than open haemorrhoidectomy group (3.37+/-2.2 vs. 2.03+/-0.81 days, p=0.003. Mean postoperative pain (observed by VAS) in the stapled group was significantly less than the open haemorrhoidectomy group (4.43+/-1.25 vs. 7.37+/-0.72). The proportion of postoperative bleeding, infection, anal tag, urinary retention, tenderness on digital rectal examination and wound discharge was higher in open than stapled haemorrhoidectomy group, but statistically insignificant (p < 0.05).

CONCLUSION

There was a significant difference between Milligan Morgan's and stapled haemorrhoidectomy for postoperative pain and hospital stay. However the mean length of operative time was insignificantly different.

Authors+Show Affiliations

Department of Genral Surgery, Jinnah Postgraduate Medical Centre, Karachi. nawaidfk@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19728941

Citation

Khan, Nawaid Farooque, et al. "Outcome of Stapled Haemorrhoidectomy Versus Milligan Morgan's Haemorrhoidectomy." Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, vol. 19, no. 9, 2009, pp. 561-5.
Khan NF, Hussain Shah SS, Bokhari I, et al. Outcome of stapled haemorrhoidectomy versus Milligan Morgan's haemorrhoidectomy. J Coll Physicians Surg Pak. 2009;19(9):561-5.
Khan, N. F., Hussain Shah, S. S., Bokhari, I., Mahboob, S., Gulfam, M. A., Ghayasuddin, M., Khan, A., & Rasul, S. (2009). Outcome of stapled haemorrhoidectomy versus Milligan Morgan's haemorrhoidectomy. Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 19(9), 561-5. https://doi.org/09.2009/JCPSP.561565
Khan NF, et al. Outcome of Stapled Haemorrhoidectomy Versus Milligan Morgan's Haemorrhoidectomy. J Coll Physicians Surg Pak. 2009;19(9):561-5. PubMed PMID: 19728941.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcome of stapled haemorrhoidectomy versus Milligan Morgan's haemorrhoidectomy. AU - Khan,Nawaid Farooque, AU - Hussain Shah,Syed Sagheer, AU - Bokhari,Iram, AU - Mahboob,Samreen, AU - Gulfam,Mansoor Akhtar, AU - Ghayasuddin,Muhammad, AU - Khan,Asadullah, AU - Rasul,Shahid, PY - 2008/08/19/received PY - 2009/05/04/accepted PY - 2009/9/5/entrez PY - 2009/9/5/pubmed PY - 2010/9/30/medline SP - 561 EP - 5 JF - Journal of the College of Physicians and Surgeons--Pakistan : JCPSP JO - J Coll Physicians Surg Pak VL - 19 IS - 9 N2 - OBJECTIVE: To compare the postoperative outcome of stapled haemorrhoidectomy and conventional Milligan Morgan's open haemorrhoidectomy. STUDY DESIGN: Comparative study. PLACE AND DURATION OF STUDY: Surgical Unit 1, Ward-3, Department of Surgery, Jinnah Postgraduate Medical Centre, Karachi, from March to September 2006. METHODOLOGY: Sixty patients of late 2nd, 3rd and 4th degree haemorrhoids were selected for admission from the outpatient department after taking informed consent. Patients with concomitant anal disease (e.g. fissure, abscess, fistula, ano-rectal cancer etc.) were excluded. Two groups of thirty each were made, one for Milligan-Morgan open haemorrhoidectomy and another for stapled haemorrhoidectomy, in which excision of a ring of mucosa proximal to the haemorrhoid(s) was done thus, interrupting the blood supply but maintaining continuity of the rectal mucosa. The operative time was measured in minutes. Postoperative pain was assessed through VAS. Bleeding was measured as no, mild, profuse. Other post-operative complications during hospital stay like urinary retention, anal stenosis etc. were noted. Student t-test, chi-square test and repeated measured analysis of variance were applied to compare the variables. RESULTS: The mean age was 40.7+/-11.6 years. A majority (53.3%) of patients (combined % in both groups) had third degree haemorrhoid. The mean length of operative time was found statistically insignificant between open and stapled groups (19.6+/-5.9 vs. 22.4+/-7.2 minutes, p=0.974). However, the mean length of postoperative hospital stay was significantly less in the stapled than open haemorrhoidectomy group (3.37+/-2.2 vs. 2.03+/-0.81 days, p=0.003. Mean postoperative pain (observed by VAS) in the stapled group was significantly less than the open haemorrhoidectomy group (4.43+/-1.25 vs. 7.37+/-0.72). The proportion of postoperative bleeding, infection, anal tag, urinary retention, tenderness on digital rectal examination and wound discharge was higher in open than stapled haemorrhoidectomy group, but statistically insignificant (p < 0.05). CONCLUSION: There was a significant difference between Milligan Morgan's and stapled haemorrhoidectomy for postoperative pain and hospital stay. However the mean length of operative time was insignificantly different. SN - 1022-386X UR - https://www.unboundmedicine.com/medline/citation/19728941/Outcome_of_stapled_haemorrhoidectomy_versus_Milligan_Morgan's_haemorrhoidectomy_ L2 - https://medlineplus.gov/hemorrhoids.html DB - PRIME DP - Unbound Medicine ER -