Document Detail


PPH vs Milligan-Morgan: early and late complications in the treatment of haemorrhoidal disease with circumferential prolapse.
MedLine Citation:
PMID:  23841953     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: The aim of this study was to assess the early and late complications of haemorrhoidectomy according to Milligan-Morgan (Milligan-Morgan laser optical fibers variant) vs haemorrhoidopexy with PPH-stapler and to assess the long-term results in terms of recurrences in circumferential prolapse patients classified P4-E4 (PATE 2000).
METHODS: Onehundredsixty patients, with haemorrhoidal disease classified P4-E4, who underwent surgery between 2001 and 2007, were included in an retrospective observational study. Group A (M-M laser fibre) 80 patients (50%) (50 Male, 30 Female; median age 39 years, range 23-57 years). Group B (PPH-Stapler) 80 patients (50%) (58 Male, 22 Female; median age 40 years, range 23-60 years).
RESULT: Early complications were thrombosis (6 cases in M-M vs 1 in PPH) and urinary retention (13 M-M vs 5 PPH). There weren't cases of sepsis. Late complications have been: occasional bleeding 13.5 % in the M-M-group vs 10 % in the PPH-group; defecatory urgency 2.5 % (M-M-group) vs 5% (PPH-group) with p < 0.1; persistent pain 2.5 % (M-M) vs 5 % (PPH) with p < 0.1; soiling 18.75 % (M-M) vs 0 % (PPH) with p < 0.001; recurrences 5 % in PPH-group vs 0 % in M-M (p < 0.05); residual disease 7.5 % in M-M-group vs 0 % in PPH p < 0.01.
CONCLUSIONS: PPH-stapler procedure for treatment of haemorrhoidal prolapse is an important improvement, but may be followed by severe complications. We think that it has a clear indication in the treatment of haemorrhoidary disease with circumferential prolapse classified P4-E4.
KEY WORDS: Haemorrhoidopexy, Haemorrhoidectomy, Laser Fiber, PATE 2000 Classification.
Abstract available from the publisher.
Authors:
Giuseppe Sammarco; Francesco Ferrari; Antonio Carpino; Emilio Russo; Giuseppina Vescio; Michele Ammendola; Rosario Sacco
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Publication Detail:
Type:  Journal Article     Date:  2013-07-23
Journal Detail:
Title:  Annali italiani di chirurgia     Volume:  84     ISSN:  2239-253X     ISO Abbreviation:  Ann Ital Chir     Publication Date:  2013  
Date Detail:
Created Date:  2013-07-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372343     Medline TA:  Ann Ital Chir     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  -     Citation Subset:  IM    
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