When compared to hemorrhoidal artery ligation and recto-anal repair (HAL-RAR), Milligan-Morgan (MM) hemorrhoidectomy had fewer recurrences and higher patient satisfaction rates in patients reporting pain, itching, or discomfort as the presenting symptoms of hemorrhoidal disease (HD), says an article published in BMC Surgery.
Several surgical approaches for hemorrhoidal disease therapy have been proposed. However, the best strategy to use for each unique case scenario is still up for dispute. The current study compared the Milligan-Morgan hemorrhoidectomy to the hemorrhoidal artery ligation and rectoanal repair procedure. Dimitrios Symeonidis and colleagues focused this study to compare the Milligan-Morgan hemorrhoidectomy with the hemorrhoidal artery ligation and recto-anal repair procedure.
A retrospective examination of a prospectively gathered database of patients undergoing HD surgery in our department was performed for this study. Patients were separated into two groups: those with MM and those with HAL-RAR. Recurrence rates and patient satisfaction were the primary end goals. To compare numerical variables, the unpaired t test was employed, whereas the x2 test was utilized for categorical data.
The key findings of this study were;
1.There were a total of 124 patients who had HAL-RAR or MM hemorrhoidectomy.
2.Eight (8) patients were lost to follow-up and were thus eliminated from the study.
3.The HAL-RAR group included 69 patients (54 males and 15 females-male / female ratio: 3.6) with a median age of 47 years old (range 18-69), whereas the MM group included 47 patients (40 males and 7 females-male / female ratio: 5.7) with a median age of 52 years old (range 32-71).
4.Researchers reported 20 recurrences (28.9%) in the HAL-RAR group and 9 recurrences (19.1%) in the MM group after a median follow-up of 41 months (minimum 24 months-maximum 72 months) (p 0.229).
5.The mean time from surgery to recurrence in the HAL-RAR group was 14.1 ± 9.74 months and 21 ± 13.34 months in the MM group.
6.When submitted to MM, patients with itching, pain, or discomfort as the presenting symptoms of HD had statistically considerably decreased recurrences and reported statistically significantly higher satisfaction rates.
7.Patients' satisfaction rates in the HAL-RAR group were considerably higher in the subgroup of patients with bleeding as the presenting symptom.
Reference:
Symeonidis, D., Spyridakis, M., Zacharoulis, D., Tzovaras, G., Samara, A. A., Valaroutsos, A., Diamantis, A., & Tepetes, K. (2022). Milligan–Morgan hemorrhoidectomy vs. hemorrhoid artery ligation and recto-anal repair: a comparative study. In BMC Surgery (Vol. 22, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12893-022-01861-z