Zafar Iqbal, Arshad Amin, Gulsharif, Zeeshan Saboor Ahmad, Mazhar Khan, Aziz Ullah.
Comparison of Stapled Hemorrhoidopexy vs Milligan Morgan Hemorrhoidectomy.
Ophthalmol Update Jan ;14(1):101-4.

Objective: To compare the postoperative outcome of stapled haemorrhoidectomy and conventional Milligan Morgan`s open haemorrhoidectomy. Materials & Methods: This is a Comparative study- a randomized control trial and was conducted in surgery unit, Hayatabad Medical Complex, Peshawar from June 2008 to May 2014. 90 patients with prolapsed hemorrhoids were selected and divided into two groups with 45 patients in each group. Patients were subject to either Milligan-Morgan Hemorrhoidectomy (MMH) or Stapled Hemorrhoidopexy (PPH). The operative time was measured in minutes. Postoperative pain was assessed through VAS (visual analogue score). Bleeding was measured as the number of packs used in the procedure. Patients were followed up in the OPD clinic with first post-operative visit after 6 weeks and all subsequent visits at 6 months interval and assessed for anal stenosis and recurrence. Results: For MMH, out of the 45 patients, male to female ratio was M:F 3:1, while in the PPH group, it was M:F 2:1. The mean age of the patient who underwent MMH was 42.8 �13.2 years while for PPH it was 42.5�11.6 years. The mean duration of procedure for MMH was 25.6�10.3 minutes whereas for PPH it was 21.2�5.6 minutes. The extent of intraoperative bleeding, for MMH was 3.2�1.2 and for PPH was 1.3�0.7. The post-operative pain was for MMH group 7.31�1.54 whereas for PPH group it came out to be 6.16�0.86. Mean length of hospital stay for MMH group was 2.7�1.1 days while for PPH group it was 1.3�0.6 days. P value is more than 0.05. Conclusion: 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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