Stapling procedure for haemorrhoids versus Milligan-Morgan haemorrhoidectomy: randomised controlled trial

Area of Science:

• Colorectal Surgery
• Surgical Innovation
• Minimally Invasive Procedures

Background:

• Hemorrhoidectomy is known for post-operative pain.
• The circular stapled technique offers a potentially less painful alternative to traditional ablative surgery.
• This study compares stapled hemorrhoidectomy with standard Milligan-Morgan hemorrhoidectomy.

Purpose of the Study:

• To compare the short-term outcomes of the circular stapled hemorrhoidectomy with the Milligan-Morgan hemorrhoidectomy.
• To evaluate post-operative pain, recovery time, and early complications.
• To assess patient-reported outcomes following both surgical procedures.

Main Methods:

• A randomized controlled trial involving 40 patients with prolapsing hemorrhoids.
• Patients were assigned to either Milligan-Morgan hemorrhoidectomy or the circular stapled procedure.
• Pain was assessed using linear analogue pain scores, with follow-up at 1, 3, and 6-10 weeks.

Main Results:

• The circular stapled group experienced significantly less average pain (p<0.0001) and a shorter time to return to normal activity (17 vs 34 days).
• Anesthesia time was shorter in the stapled group (median 18 vs 22 minutes).
• Hospital stay and time to first bowel motion did not differ significantly; early complications and symptom control were similar.

Conclusions:

• The circular stapled hemorrhoidectomy is a less painful alternative to Milligan-Morgan hemorrhoidectomy.
• This technique is associated with an earlier return to normal activities.
• Long-term symptomatic and functional outcomes require further investigation.