Stapled and conventional Milligan-Morgan haemorrhoidectomy: different solutions for different targets

Area of Science:

• Colorectal Surgery
• Gastroenterology

Background:

• Haemorrhoidal disease is a prevalent anorectal condition.
• Surgical interventions aim to alleviate symptoms and improve patient outcomes.

Purpose of the Study:

• Compare stapled haemorrhoidopexy (SH) with Milligan-Morgan haemorrhoidectomy (M&M) over a decade.
• Determine optimal indications for each technique based on complication rates and long-term results.

Main Methods:

• A comparative study of 343 patients with symptomatic haemorrhoids undergoing SH or M&M (2005-2007).
• Patients were age and sex-matched.
• Data collected included pain medication, antibiotic/laxative use, complications, and hospital stay.

Main Results:

• SH had shorter operative times (31 vs. 40 min) and quicker recovery (less pain, shorter hospital stay).
• Wound healing time differed significantly between groups.
• A higher recurrence rate was observed with SH for fourth-degree haemorrhoids.

Conclusions:

• The Longo technique (SH) is suitable for second- and third-degree haemorrhoids.
• Milligan-Morgan haemorrhoidectomy (M&M) is effective for severe prolapse and irreducible cases.
• Surgical choice depends on surgeon preference and individual patient needs.