Comparison of clinical efficacy and safety of two kinds of surgical method in the treatment of mixed hemorrhoids for III~IV stage combined with internal rectal mucosal prolapsed

Abstract

Objective To compare the clinical efficacy and safety of two kinds of surgical method including Milligan-Morgan haemorrhoidectomy and automatic ligation of hemorrhoids in the treatment of mixed hemorrhoids for Ⅲ-Ⅳ stage combined with internal rectal mucosal prolapse. Methods From March 2013 to July 2015, 100 patients with mixed hemorrhoids for Ⅲ-Ⅳ stage combined with internal rectal mucosal prolapse were chosen in the Traditional Chinese Medicine Hospital of Qingyuan County, and they were randomly divided into two groups according to the digital table, with 50 patients in each group.A group received Milligan-Morgan haemorrhoidectomy, and B group received automatic ligation of hemorrhoids.The clinical effect, the level of clinical indicators in peri-operative period, the scores of pain, bleeding, anal edema and dysuria after treatment and the skin tag formation rate of the two groups were compared. Results The short-term effective rates of A group and B group were 76.00%, 96.00%, respectively.The clinical effect of B group was better than that of A group, and the difference was statistically significant(χ2=7.73, P<0.05). The operation time, blood loss volume, wound healing time and total hospitalization time of A group were(20.97±4.52)min, (12.47±1.65)mL, (25.48±3.76)d, (15.55±4.38)d, respectively, which of B group were(12.01±2.54)min, (7.29±1.02)mL, (20.24±2.18)d, (12.02±3.82)d, respectively.The levels of clinical indicators in peri-operative period of B group were better than those of A group, and the differences were statistically significant(t=2.74, 3.02, 2.84, 3.46, all P<0.05). The scores of pain, bleeding, anal edema and dysuria after treatment of B group were lower than those in A group and before treatment, the differences were statistically significant(t=2.67, 2.50, 3.04, 2.76, all P<0.05). The skin tag formation rate of B group was lower than that of A group and before treatment, and the difference was statistically significant(χ2=8.77, P<0.05). Conclusion Compared with Milligan-Morgan haemorrhoidectomy, automatic ligation of hemorrhoids in the treatment of mixed hemorrhoids for III-IV stage combined with internal rectal mucosal prolapse can efficiently relieve the clinical symptoms and signs, promote wound healing and is helpful to reduce the postoperative complications risk. Key words: Hemorrhoids; Haemorrhoidectomy; Ligation