Effect of mixed hemorrhoid after tissue-selecting therapy stapler combined with Milligan-Morgan hemorrhoidectomy on recovery and recurrence of anorectal motility in mixed hemorrhoid patients

Abstract

Objective To investigate the curative effect of tissue-selecting therapy stapler (TST) combined with Milligan-Morgan hemorrhoidectomy in mixed hemorrhoids patients, and the influences on anorectal motility recovery and recurrence. Methods From December 2014 to December 2016, sixty-five cases of mixed hemorrhoids diagnosed by People’s Hospital of Taishan District were selected. According to the treatment methods, they were divided into control group (33 cases, underwent Milligan-Morgan hemorrhoidectomy) and combined group (32 cases, underwent Milligan-Morgan hemorrhoidectomy+TST). The anorectal motility levels, including length of high pressure zone (HPZ), anal anal resting pressure (ARP), maximums systolic pressure (MSP), were measured at preoperation and 6 months after the operation. The curative effect, complications and recurrence between the two groups were statistically analyzed after 6 months of follow-up. Results There was no surgical failure in the two groups. Operation time of the control group was significantly less than that of the combined group, the intraoperative bleeding of the control group was significantly higher than that in the combined group, with statistically significant differences (t=5.627, 14.939, both P<0.001). The effective rates of the combined group and the control group were 93.75% (30/32), 87.88% (29/33), respectively, and the difference was not statistically significant (χ2=1.513, P=0.469). There was no significant difference in anorectal motility between the two groups before operation. But after 6 months, the levels of HPZ, ARP and MSP in the combined group were significantly higher than those in the control group (χ2=5.791, 5.120, 4.978, all P<0.01). And 6 months after operation, the complication rate and recurrence rate in the combined group were significantly lower (χ2=4.447, 5.107, P=0.035, 0.024). Conclusions Compared with Milligan-Morgan hemorrhoidectomy, TST combined with Milligan-Morgan hemorrhoidectomy is curative for the mixed hemorrhoids patients. It can effectively reduce the incidence of complications, prevent recurrence, is good for anorectal dynamic recovery, and worthy of further promotion in clinical practice. Key words: Hemorrhoids; Tissue-selecting therapy stapler; Milligan-Morgan hemorrhoidectomy; Anorectal motility; Recurrence