Hemorredectomy: Evaluation of Techniques and Satisfaction

A number of surgical procedures have been suggested as potential treatments for hemorrhoidal disease (HD). Still up for discussion, however, is which method is best suited to deal with certain situations. The researchers in this study set out to see how the Milligan-Morgan (MM) hemorrhoidectomy stacked up against the HAL-RAR method. We performed a retrospective study on the database of patients who had HD surgery in our department, which had been prospectively gathered. The MM group and the HAL-RAR group were the two sets of patients that were studied. Both the recurrence rate and the patient satisfaction rate were considered primary end goals. For numerical variables, we used the unpaired t test, and for categorical variables, we utilized the x2 test.

The outcomes are: A total of sixty-two individuals were selected for hemorrhoidectomy, with the option to undergo HAL-RAR or MM. Four (4) patients were not included in the analysis due to not being followed up. Of the remaining 58 patients, 35 (27 men and 8 females) with a median age of 47 (range 18-69) were part of the HAL-RAR group, and 22 (nineteen males and three females) with a median age of 52 (range 32-71) were a part of the MM group. Out of a total of 72 months of followup, 12 occurred in the HAL-RAR group and 4 in the MM group at a median follow-up of 41 months (p 0.229). In the HAL-RAR group, the average period between the surgery and recurrence was 14.1 ± 9.74 months, whereas in the MM group, it was 21 ± 13.34 months. Subjected to MM, patients whose primary symptoms of HD were itching, pain, or discomfort had considerably fewer recurrences (p 0.0354) and reported much higher satisfaction ratings (6.72 ± 2.15 vs. 8.11 ± 1.99—p 0.0111). Patients in the HAL-RAR group reported substantially higher levels of satisfaction (8.59 ± 1.88 vs. 6.45 ± 2.70— p 0.0013) when bleeding was the presenting symptom in the subgroup of patients.  Final thoughts: Compared to HAL-RAR, MM resulted in lower recurrence rates and higher patient satisfaction ratings in HD patients whose first symptoms were pain, itching, or discomfort. Compared to MM, HAL-RAR resulted in higher patient satisfaction and equal recurrence rates in individuals whose bleeding was the primary presenting symptom of HD.