Clinical Control Study Of Complications Efficacy Of Procedure For Prolapse And Hemorrhoids And Milligan-Morgan

[Objective] This study aimed to compare PPH to Milligan-Morgan surgery in the efficacy, the incidence of short-term and long-term complications, the hospital costs and the quality of life in severe internal hemorrhoids; And to investigate whether PPH can block the terminal branches of the superior rectal artery (SRA) by detect the blood flow using non-invasive trans-anal ultrasound doppler.To explore the status of PPH and MM in efficacy,operative mechanism and medical economics in order to provide evidence for the treatment of severe internal hemorrhoids. [Methods] To collect the clinical datas of patients who were conduct PPH or MM in Nanjing Chinese Medicine Hospital, National Medical Center of Anorectal disease from 2005.2 to 2008.3.Totally 88 patients,44 cases of PPH group,44 cases of MM group follow-up from 6-12 months.The main index include the long-term complications, cost in hospital, quality of life and postsurgical satisfaction. Totally 98 patients in 2009,48 cases of PPH group,50 cases of MM group, to evaluate perioperative and short-term complications of PPH and MM. randomly chose 20 cases from the 48 cases who underwent PPH in 2009 then scanned blood flow by trans-anal colour Doppler ultrasound (CDUS) three months after operation. Ten healthy volunteers served as the control group. Arterial caliber (AC) and arterial flow velocity (AFV) of the terminal branches of the superior rectal artery were measured. [Results] There is no statistically significant difference in the pain and edema between PPH group and MM in 24h after operation (P>0.05). There is statistically significant difference in the urine retention between PPH group and MM in 24h after operation (P<0.05).The recurrence rate and long-term complications of PPH are higher than MM (P<0.05).There is no statistically significant in the satisfaction between two groups by theχ2 test analysis, P=0.831 (P>0.05). There is no statistically significant between two groups in the quality of life by SF-36. [Conclusion] The recurrence and incidence of long-term complication of PPH are higher than the MM. PPH is not better than MM in pain control, edema and satisfaction.The urine retention occurs more frequenly in PPH than MM. Although there is no differences in the quality of life between PPH group and MM group. But the cost of PPH is higher than MM. PPH is inferiorer than MM in the medical economics. PPH can not decrease the vessels flow of the anorectal vascular plexus.To deduce theoryly that PPH can block the vessel flow of hemhorrid remain to be proved.Traditional hemorrhoidectomy treatment is the gold standard.