A Comparative Study on Post-operative Outcomes of Stapled Haemorrhoidopexy versus Milligan–Morgan Haemorrhoidectomy in Patients above 60 Years

Abstract

Abstract Background: Haemorrhoidal disease is one of the most common benign anorectal pathologies worldwide. Plethora of treatment options available for haemorrhoids. Stapled haemorrhoidopexy and Milligan–Morgan haemorrhoidectomy were commonly done surgeries. Aim: we compared the short-term post-operative outcomes of stapled haemorrhoidopexy with Milligan–Morgan haemorrhoidectomy in patients aged above 60 years. Materials and Methods: It was a prospective, observational, comparative study from August 2020 to May 2022 on 100 patients above 60 years admitted to the general surgery departments with a diagnosis of third- and fourth-degree haemorrhoids and underwent stapled haemorrhoidopexy and Milligan–Morgan haemorrhoidectomy were included in the study after applying inclusion and exclusion criteria. Results: In stapled haemorrhoidopexy, mild pain is experienced in 44 (88%) patients and moderate pain in only 6 (12%) patients compared to 38 (76%) patients in Milligan–Morgan haemorrhoidectomy experience mild pain and 12 patients (24%) had moderate pain in 1st post-operative day. Anal incontinence is present in 12 (24%) patients of Milligan–Morgan surgical candidates and 3 (6%) patients of stapled haemorrhoidectomy patients on 1st post-operative day. First post-operative day 11 patients (22%) of Milligan–Morgan surgery developed urinary retention, whereas 6 patients (12%) of stapled surgery showed urinary retention. Forty-five (90%) patients resumed to normal activities within 1 week following Milligan–Morgan haemorrhoidectomy. Forty-six (92%) patients resumed to normal activities within 1 week following stapled haemorrhoidopexy. The average operating time for stapled haemorrhoidopexy was 33.0 min and Milligan–Morgan haemorrhoidectomy was 45.6 min. Thirty-nine (78%) patients were discharged 2 days after Milligan–Morgan haemorrhoidectomy and 3 (6%) patients were discharged 2 days after stapled haemorrhiodopexy. Eleven (22%) patients were discharged 2 days after Milligan–Morgan haemorrhoidectomy and 47 (94%) patients were discharged 2 days after stapled haemorrhiodopexy. Conclusion: We found that stapled haemorrhoidopexy is a better alternative compared to Milligan–Morgan haemorrhoidectomy as it outweighs the latter in terms of short-term post-operative outcomes included in the study.