Long-term outcome of a multicentre randomized clinical trial of stapled haemorrhoidopexy versus Milligan-Morgan haemorrhoidectomy

Br J Surg. 2007 Aug;94(8):1033-7. doi: 10.1002/bjs.5677.

Abstract

Introduction: Stapled haemorrhoidopexy is less painful than Milligan-Morgan haemorrhoidectomy, allowing an earlier return to working activities, but its long-term efficacy is not fully established. This study reports the long-term follow-up of a randomized clinical trial comparing the two techniques in 100 patients affected by third- and fourth-degree haemorrhoids.

Methods: All patients were contacted and invited to attend the clinic to assess long-term functional outcome. The degree of continence and satisfaction were assessed by questionnaire. Anal manometry and anoscopy were performed.

Results: Eighty patients were available after a median follow-up of 87 months. No statistically significant differences were found between the two groups in terms of incontinence, stenosis, pain, bleeding, residual skin tags or recurrent prolapse. A tendency towards a higher recurrence rate was reported in patients with fourth-degree haemorrhoids, irrespective of the technique used. No significant changes in anal manometric values were found after surgery in either group.

Conclusion: Both techniques are effective in the long term.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Defecation / physiology
  • Fecal Incontinence / etiology*
  • Female
  • Hemorrhoids / physiopathology
  • Hemorrhoids / surgery*
  • Humans
  • Male
  • Manometry
  • Middle Aged
  • Patient Satisfaction
  • Postoperative Complications / etiology*
  • Recurrence
  • Surgical Stapling*
  • Treatment Outcome