Muhammad Zarin, Maryam Alam Khan, Haider Kamran, Tariq Saeed Akhunzada, Bilal Ahmad, Waqas Khalil.
Comparison Of PPH Hemorrhoidectomy VS Milligan Morgan Hemorrhoidectomy.
J Med Sci Jan ;23(4):213-6.

Objectives: To compare the Milligan Morgan Hemorrhoidectomy (MMH) with Procedure for Prolapse Hemorrhoids (PPH ) in terms of per-operative and post-operative outcomes. Material and Methods: This Prospective randomized clinical trial was conducted at Surgical Department of Khyber Teaching Hospital, Peshawar, from January 2011 to April 2014 on 105 patients who presented with prolapsed hemorrhoids. The patients were randomly allocated into Group A (MMH ) and Group B (PPH) using lottery method. Various per operative and post-operative variables were studied and compared. Results: There were 60 patients in Group A and 45 in group B. The operative time was significantly lower is Group B (25 vs 35 minutes), mean length of hospital stay was also shorter (2 vs 4 days). However, average cost per procedure for Group B is significantly higher (23500 PKR vs 7000 PKR). Patients in Group B experienced lesser post-op pain (VAS=4.5vs2.0) and recurrence (11.6% vs 6.6%) as compared to Group A. Conclusion: Procedure for Prolapse Hemorrhoids (PPH) requires operator training and is less recognized in Pakistan but due to its excellent postoperative results, patient satisfaction and being a day care procedure, it should be adopted as primary treatment in prolapsed hemorrhoids.

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