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Outcome of stapled haemorrhoidectomy versus Milligan Morgan's haemorrhoidectomy.

Authors: Nawaid Farooque, Khan; Syed Sagheer, Hussain Shah; Iram, Bokhari; Samreen, Mahboob; Mansoor Akhtar, Gulfam; Muhammad, Ghayasuddin; Asadullah, Khan; +1 Authors

Outcome of stapled haemorrhoidectomy versus Milligan Morgan's haemorrhoidectomy.

Abstract

To compare the postoperative outcome of stapled haemorrhoidectomy and conventional Milligan Morgan's open haemorrhoidectomy.Comparative study.Surgical Unit 1, Ward-3, Department of Surgery, Jinnah Postgraduate Medical Centre, Karachi, from March to September 2006.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.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).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.

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Keywords

Adult, Male, Analysis of Variance, Postoperative Pain, Suture Techniques, Anal Canal, Length of Stay, Hemorrhoids, Treatment Outcome, Surgical Stapling, Humans, Female, Digital Rectal Examination, Pain Measurement

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
3
Average
Average
Average
gold
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