Milligan-Morgan Hemorrhoidectomy vs Stapled Hemorrhoidopexy

Background: The stapled hemorrhoidopexy (SH) is a procedure for prolapse and hemorrhoids . At first SH seemed to be a good alternative for the Milligan Morgan (MM) hemorrhoidectomy and preliminary results in early ۲۰۰۰ confirmed it. However, further studies and evaluation of long-term results showed poorer outcomes. Objectives: This study aimed to evaluate and compare the results of these ۲ surgical procedures in terms of recovery, improvement of symptoms and incidence of complications. Materials and Methods: This study was conducted from April ۲۰۰۸ to August ۲۰۱۰. A total of ۸۰ patients were divided into ۲ groups of ۴۰ each. In the SH group, there were ۲۴ males (۶۰%) and ۱۶ females (۴۰%) with a mean age of ۴۸ ± ۱۲.۵ yrs. In the MM group, there were ۳۰ males (۷۵%) and ۱۰ females (۲۵%) with a mean age of ۵۰.۶ ± ۱۷.۳ yrs. Patients with grade ۳ and ۴ prolapsed hemorrhoids were entered in the study. Data were entered using SPSS software and analyzed using t-test and Chi-square test. Results: The two groups had no significant difference in terms of age or sex. Duration of surgery was ۳۵ ± ۷ minutes in the SH and ۲۳.۶ ± ۱۳.۵ minutes in the MM group. This difference was statistically significant (P = ۰.۰۰۰). Post-operative pain and complete pain relief was slightly lower in the MM group (not significant). Hospital stay was significantly longer in the MM group (P = ۰.۰۰۳). Return to work was similar in both groups. Three patients in the SH group (۷.۵%) and ۲ in the MM group (۵%) had hemorrhoid recurrence. Conclusions: Both techniques are efficient treatment methods for grade III and IV hemorrhoids and are associated with greater than ۹۵% recovery rate. Overall, outcomes are the same in both techniques. Lower postoperative pain was the only advantage of SH over MM technique.