The Milligan-Morgan operation in the surgical treatment of hemorrhoids: Survey of 828 cases

Abstract

Purpose: Patients with prolapsing internal hemorrhoids were treated with Milligan-Morgan hemorrhoidectomy (MMH) technique, and the results were evaluated.

Materials and Methods: From January 2000 to January 2009, 828 consecutive hemorrhoidal patients underwent Milligan-Morgan technique. The patients records were examined, symptoms, associated with anorectal disease, operative findings, early and late postoperative complications were recorded.

Results: 70% were males and the mean age was 44 (17-76) years. Range of complaint duration was between 1 month to 5 years and according to the frequency prolapsing piles, bleeding, and anemia respectively. Prolapsing piles were located at classical (h 3.7.11) location in 74% of the patients. The majority (68%) had grade 4 hemorrhoids. 23% of our patients had associated anorectal disease (anal fissure). All procedures were performed under general anesthesia with the patient in lithotomy position. The mean operative time was 25 min. Postoperative complications occurred in 72 patients in early period. Of all patients, 4.2% complained of mild rectal pain for a postoperative period, 3.9% developed post-operative urinary retention, managed with catheterization, 1.7% developed hemorrhage. The most common early postoperative complication was anal fissure seen in 5 patients followed by anal stenosis (2 patients), and anal fistula-abscess developed in one patient. In patients treated with MMH, incontinence, and disease recurrence were not observed.

Conclusion: The Milligan-Morgan hemorrhoidectomy is still one of the most popular surgical treatments of hemorrhoids The authors conclude that the Milligan-Morgan technique is to be preferred because of its effectivity and safety.