[Results two years after stapler hemorrhoidectomy versus Milligan-Morgan procedure].
The aim of this investigation was to demonstrate possible advantages of stapler hemorrhoidectomy in comparison to the Milligan-Morgan procedure. 96 patients with an average age of 54 years were treated in a two year period (7/1998-8/2000) by stapler hemorrhoidectomy. The complication rate was 12.5 % and included one mechanical stapler defect, two cases of bleeding, five cases of urinary retention and four of perianal edema. The use of analgesics was small with 70 % requiring no medication at all. Hospitalisation post-operatively was 3.3 days with patients under 65 years old and 4.7 days in those over 65 years. These data were compared retrospectively to that of Milligan-Morgan hemorrhoidectomy (214 patients) performed between January 1990-December 1997. The stapler patients had less pain, fewer complications and shorter hospitalisation. Using a questionnaire, all stapler patients and 50 Milligan-Morgan controls were evaluated. 78 % responded at 13.8 months after stapler hemorrhoidectomy, 63 % 54.1 months after Milligan-Morgan. The degree of satisfaction was high in both groups (93 vs 94 %). One patient in the Milligan-Morgan group suffered a recurrence. No further symptoms had been experienced by 57 % after stapler, 68 % after Milligan-Morgan procedure. Faecal continence represents a problem in the stapler group. Stapler hemorrhoidectomy is an effective treatment for IIIrd degree hemorrhoids. In comparison to the Milligan-Morgan procedure, it has advantages in the early post-operative period. Defecation problems can occur with an unknown prognosis. Without long-term results and because of the comparatively high cost of the procedure the indication for stapler hemorrhoidectomy should be carefully made.
Ebert
K-H
KH
Chirurgische Klinik, St. Martinus-Hospital gGmbH, Olpe. chirurg.oe@t-online.de
Meyer
H J
HJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010149:Postoperative Pain / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology*; D013528:Surgical Staplers