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2007 Program and Abstracts | 2007 Posters
Surgical Treatment of Hemorrhoids in Day Surgery: Longo Vs Milligan Morgan Technique
Vito M. Stolfi*, Pierpaolo Sileri, Marco Venza, Sara Di Carlo, Achille Gaspari
Surgery, University of Rome Tor Vergata, Rome, Italy

In the past few years some studies have demonstrated that surgical treatment of hemorrhoids in a day care basis is possible and safe. The aim of the study was to compare two surgical techniques, the Longo stapled prolassectomy and Milligan Morgan technique for the treatment of hemorrhoids.303patients were treated in Day Surgery in the division of General Surgery I of the University Hospital “Tor Vergata” in period between 01/2003 and 09/2006. Patients where operated in local anesthesia performed by infiltration of 20 ml of naropine 7.5. Surgical technique was Longo in 86 cases, Milligan Morgan in 34 cases. 77cases were III degree hemorrhoids, 43 IV degree. Visual analogue scale (VAS) was used for pain evaluation, Student t test for statistical evaluation. Data was prospectivelly collected and results between Longo and Milligan Morgan compared.Surgical time was 21±8.7 min. for Longo prolassectomy and 27,8± 9,9 in Milligan Morgan techniqe(p=0,84). Postoperative pain was not different between Milligan Morgan and Longo techniques during first 3 days after surgery (4,8±3,1 vs. 5,0±4,0 P=0,8), during the following 5 days patient treated with Longo technique had less pain (3,0±2,5 vs 4,5±2,6; P=0,002). 80 patients operated by Longo prolassectomy were treated in day care, 5 in one day surgery (5,8%) and 3 required further admission for complicated course (2,0%). All of 34 patients operated with Milligan Morgan hemorrhoidectomy were treated in day care. Other results of the study were as follows: LONGO MILLIGAN MORGAN Pain duration (days)15,1 ± 17,1 19,4 ± 14,6 P=0,3Secretion time 5,4 ± 9,3 19,2 ± 13 P=0,003Bleeding duration 6,4 ± 8,5 19 ± 14,9 P=0,003Return to work 17,3 ± 10,8 16,7 ± 10,1 P=0,8Complications of the thecniques in our study were as follows: LONGO 86 MILLIGAN MORGAN 34 Skin tags 13 (15,%) 8 (25%) P=0,2Anal hemorrhage 2 (2,3%) 1 (3,1%) P=0,7Anal fissure 5 (5,8%) 0 P=0,1Urgency 2 (2,3%) 0 P=0,3Urinary retention 3 (3,4%) 0 P=0,2Anal stricture 1 (1,1%) 1 (3,1%)P=0,4Recurrence 3 (3,4%) 0 P=0,6Treatment of hemorrhoids is feasible and safe in day care. With regard to Milligan-Morgan vs. Longo technique, we found that postoperative pain is not significantly different in the first three days after surgery while is less during the next five days. Pain duration is significantly less in Longo technique as well as secretion time and postoperative bleeding discharge duration. Longo technique, which is more expensive, gives better results than Milligan-Morgan in terms of Pain duration, discharge and haemorrage time.


2007 Program and Abstracts | 2007 Posters
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