Comparison Of The Long-term Effects Between Procedure For Prolapse And Hemorrhoids And Milligan-Morgan Hemorrhoidectomy In The Treatment Of Ⅲ,Ⅳ Degrees Of Hemorrhoids

Objective: To evaluate the long-term effects of procedure for prolapse and hemorrhoids (PPH) and Milligan-Morgan haemorrhoidectomy (MMH) in the treatment of III, IV degrees of hemorrhoids.Methods: One hundred patients were randomly divided into two groups and received PPH (n = 42) and MMH (n = 58), respectively. Long-term efficacy, complications and function of defecation were compared.Results: (1) On the long-term efficacy, there were no statistical differences in the morbidities of pruritus (4.76% vs 17.24%, P =0.058), pain (2.38% vs 3.45%, P =1.000), bleeding (2.38% vs 5.17%, P =0.852), overall symptoms recurrence rate(19.05% vs 25.86%, P =0.424) and patients satisfactory degree (92.86% vs 87.93%, P = 0.636) between the two groups. Statistics showed that the relapse rates in the two groups were similar (P =0.549) although it did not seem to be so at first glance (14.29% vs 10.34%).However, the rate of anus hydrorrhea (2.38% vs 20.69%, P =0.007) was lower in PPH group than that in MMH group (P<0. 01). (2) On the long-term complications, anal fissure ,anal fistula ,completely anal incontinence, anal stenosis, perianorectal infection did not occur to the patients in two groups. However, the rates of dermal neoplasm formation and overall complication (9.52% vs 25.86%, P =0.040) were lower in PPH group than that in MMH group (P<0. 05). (3) On the long-term function of defecation, tenesmus did not occur, and statistics did not show differences in the morbidities of constipation (7.14% vs 6.90%, P =1.000), bowel movement (2.38% vs 8.62%, P =0.384) between the two groups. However, the morbidity of narrowing in the caliber of the stools(2.38% vs 18.97%, P =0.027) and the overall abnormal function of defecation (9. 52% vs 29. 31 %, P =0. 017) were lower in PPH group than that in MMH group (P<0. 05).Conclusion: In the term of long-term effects in the treatment of III, IV degrees of hemorrhoids, procedure for prolapse and hemorrhoids, as well as Milligan-Morgan haemorrhoidectomy, is efficient option. Furthermore, its safety is higher and its complications and the abnormal function of defecation are less than those in the latter. However, in the treatment of kinds of hemorrhoids it require further studies whether PPH could substitute for MMH.