Abstract

BACKGROUND: The stapled hemorrhoidopexy (SH) is a procedure for prolapse and hemorrhoids . At first SH seemed to be a good alternative for the Milligan Morgan (MM) hemorrhoidectomy and preliminary results in early 2000 confirmed it. However, further studies and evaluation of long-term results showed poorer outcomes. OBJECTIVES: This study aimed to evaluate and compare the results of these 2 surgical procedures in terms of recovery, improvement of symptoms and incidence of complications. MATERIALS AND METHODS: This study was conducted from April 2008 to August 2010. A total of 80 patients were divided into 2 groups of 40 each. In the SH group, there were 24 males (60) and 16 females (40) with a mean age of 48 +/- 12.5 yrs. In the MM group, there were 30 males (75) and 10 females (25) with a mean age of 50.6 +/- 17.3 yrs. Patients with grade 3 and 4 prolapsed hemorrhoids were entered in the study. Data were entered using SPSS software and analyzed using t-test and Chi-square test. RESULTS: The two groups had no significant difference in terms of age or sex. Duration of surgery was 35 +/- 7 minutes in the SH and 23.6 +/- 13.5 minutes in the MM group. This difference was statistically significant (P = 0.000). Post-operative pain and complete pain relief was slightly lower in the MM group (not significant). Hospital stay was significantly longer in the MM group (P = 0.003). Return to work was similar in both groups. Three patients in the SH group (7.5) and 2 in the MM group (5) had hemorrhoid recurrence. CONCLUSIONS: Both techniques are efficient treatment methods for grade III and IV hemorrhoids and are associated with greater than 95 recovery rate. Overall, outcomes are the same in both techniques. Lower postoperative pain was the only advantage of SH over MM technique.