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01.06.2015 | Original Article | Ausgabe 3/2015

European Surgery 3/2015

Stapled hemorrhoidopexy versus Milligan–Morgan hemorrhoidectomy: a short-term follow-up on 640 consecutive patients

Zeitschrift:
European Surgery > Ausgabe 3/2015
Autor:
MD A. Cariati
Wichtige Hinweise
In case of acceptance copyright will became property of the journal

Summary

Background

The aim of the present study is to report our data on the treatment of third-and fourth-degree hemorrhoids with stapled technique and Milligan–Morgan operation in terms of postoperative results, costs, and recurrence.

Methods

From 2008 to 2011, 640 consecutive patients with third- and fourth-degree hemorrhoids underwent hemorrhoidectomy or hemorrhoidopexy. Patients have been randomly assigned to Milligan–Morgan or stapled treatment according to the possibility of use 60 staplers/year. In all, 400 patients have been treated by Milligan–Morgan procedure: 357 in one-day surgery; 240 patients underwent stapled hemorrhoidopexy: 197 in one-day surgery (p = 0.011).

Results

Immediate readmissions have been: 5 cases among Milligan–Morgan group and of 9 cases among stapled group (p two-tailed = 0.049). Acute postoperative rectal bleeding with readmission have been: 4 cases among Milligan–Morgan group (1 %) and 8 cases among stapled group (3.33 %) (p = 0.037). Recurrence have been: 2 patients after Milligan–Morgan procedure (0.5 %) and 20 patients after stapled operation (8.33) (p < 0.0000011). Total direct costs have been 668 € higher for each stapled patient.

Conclusion

In conclusion, Milligan–Morgan hemorrhoidectomy for third- and fourth-degree hemorrhoids is superior to stapled operation when comparing hospital stay, major postoperative bleeding, hospital cost, and recurrence.

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