Advertisement

Hemorrhoidal stapler prolapsectomy vs. Milligan-Morgan hemorrhoidectomy: a long-term randomized trial

  • A. RacalbutoEmail author
  • I. Aliotta
  • G. Corsaro
  • R. Lanteri
  • A. Di Cataldo
  • A. Licata
Original Article

Abstract

Background and aims

The notable success of stapled prolapsectomy in recent years led us to compare this technique with Milligan-Morgan hemorrhoidectomy in terms of the results obtained both in the immediate postoperative period and in the long term.

Patients and methods

We performed conventional hemorrhoidectomy on 50 randomly selected patients and operated on a further 50 using the stapler technique. The patients were monitored over the immediate postoperative period (e.g., type of anesthesia, mean duration of operation, mean hospitalization time, analgesic administration, time before returning to work) and over a long-term follow-up period of 48 months (later complications such as prolapse relapse, bleeding, stenosis, incontinence).

Results

The stapled group experienced significantly less pain (mean number of analgesic tablets 2.60 vs. 15.9) and returned to normal activity sooner (8.04 vs. 16.9 days), as reported by other authors. In the long-term follow-up at 48 months, stapled hemorrhoidectomy was found to control prolapse, discharge, and bleeding, with no stenosis or significant incontinence, in 94% of cases.

Conclusion

Our conclusions confirm the excellent advantages of stapled hemorrhoidectomy which allows the rapid recovery of patients and also promises the complete resolution of hemorrhoidal prolapse in the long term.

Keywords

Hemorrhoidal prolapse Stapler hemorrhoidectomy Long-term randomized trial 

References

  1. 1.
    Rowsel M, Bello M, Hemigway DM (2000) Circumferential mucosectomy (stapled haemorrhoidectomy) versus conventional haemorrhoidectomy: randomised controlled trial. Lancet 355:779–781CrossRefPubMedGoogle Scholar
  2. 2.
    Mehigan BJ, Monson JRT, Hartley JE (2000) Stapling procedure for haemorrhoids versus Milligan-Morgan haemorrhoidectomy: randomised controlled trial. Lancet 355:782–785CrossRefPubMedGoogle Scholar
  3. 3.
    Fazio VW (2000) Early promise of stapling technique for haemorrhoidectomy. Lancet 355:768–769CrossRefPubMedGoogle Scholar
  4. 4.
    Shalaby R, Desoky A (2000) Randomized clinical trial of stapled versus Milligan-Morgan haemorrhoidectomy. Br J Surg 88:1049–1053CrossRefGoogle Scholar
  5. 5.
    Ganio E, Altomare DF, Gabrielli F, Milito G, Canuti S (2001) Prospective randomized. multicentre trial comparing stapled with open haemorrhoidectomy. Br J Surg 88:669–674PubMedGoogle Scholar
  6. 6.
    Ho YH, Seow-Cohen F, Tsang C, Eu KW (2001) Randomized trial assessing anal sphincter injuries after stapled haemorrhoidectomy. Br J Surg 88:1449–1455CrossRefPubMedGoogle Scholar
  7. 7.
    Engel AE, Eijsbouts QAJ (2000) Haemorrhoidectomy: painful choice. Lancet 355:2253–2254Google Scholar
  8. 8.
    Ortiz H, Marzo J, Armedariz P (2002) Randomized clinical trial of stapled haemorrhoipexy versus conventional diathermy haemorrhoidectomy. Br J Surg 89:1376–1381CrossRefGoogle Scholar
  9. 9.
    Jorge JMN, Wexner SI (1993) Etiology and management of faecal incontinence. Dis Colon Rectum 36:77–97PubMedGoogle Scholar
  10. 10.
    Cheetham MJ, Mortensen NJM, Nystrom PO, Kamm MA, Phillips RK (2000) Persistent pain and faecal urgency after stapled haemorrhoidectomy. Lancet 356:730–733CrossRefPubMedGoogle Scholar
  11. 11.
    Succi L, Russello D, Racalbuto A, Scilletta B, Carnazza M, Scuderi M, Favetta A, Latteri F (1989) Valutazione dei risultati a distanza dopo emorroidectomia secondo Milligan-Morgan. Riv Ital Colonproctol 8:131–136Google Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • A. Racalbuto
    • 1
    • 2
    Email author
  • I. Aliotta
    • 1
  • G. Corsaro
    • 1
  • R. Lanteri
    • 1
  • A. Di Cataldo
    • 1
  • A. Licata
    • 1
  1. 1.Department of Surgical Sciences, Organ Transplant and Advanced Technologies, O.U. General SurgeryCatania UniversityCataniaItaly
  2. 2.San Giovanni La PuntaItaly

Personalised recommendations