Evaluation of Post-Operative Complications after Milligan- Morgan Hemorrhoidectomy versus Stapled Hemorrhoidopexy techniques

Abstract

Hemorrhoidal disease is considered as one of the commonest ano-rectal diseases. Non-surgical measures whatever drug therapy or office procedures, can be presented to the patients with stage 1 and stage 2 piles. However, when these measures fail, surgical intervention must be thought especially for the patients with stage 3 and stage 4 hemorrhoids. Surgical intervention should be tailored to each patient in accordance of the seriousness of symptoms and the magnitude of the external anorectal element, moreover the presence of any concurrent ano-rectal morbidity. Currently, there are numerous surgical interventions available for treatment of prolapsing piles disease and most of them yielding acceptable success rates. Conventional Haemorrhoidectomy (CH) whatever open (Milligan Morgan) or closed (Ferguson), is considered the gold standard for surgical intervention of pile but due to the severe associated post-operative pain, especially with defecation, Stapled Haemorrhoidopexy (SH) seems to offer shorter operative time, less post-operative pain, less bleeding and anal stenosis and also less time off work in comparison with CH. Although rare but horrible complications have been noted with SH, which dictate that SH should be performed only by experienced surgeons. Eventually we strongly recommend the use of stapler devices for hemorrhoidectomy when and where possible. Especially for high grade and prolapsing hemorrhoids