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


CONCLUSIONS
Both techniques are effective in the long term.
Ganio
E
E
Department of Emergency and Organ Transplantation, Section of General Surgery and Liver Transplantation, University of Bari, Policlinico, Piazza G. Cesare 11, 70124 Bari, Italy.
Altomare
D F
DF
Milito
G
G
Gabrielli
F
F
Canuti
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003672:Defecation / Q000502:physiology; D005242:Fecal Incontinence / Q000209:etiology*; D005260:Female; D006484:Hemorrhoids / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology*; D012008:Recurrence; D017792:Surgical Stapling; D016896:Treatment Outcome