Our Summary

This study compared two types of surgery for severe hemorrhoids: modified Park’s submucosal hemorrhoidectomy (MPSH) and Milligan-Morgan hemorrhoidectomy (MMH). The researchers looked at how well each procedure worked in the short and long term for 186 patients with severe hemorrhoids.

The researchers found that both procedures were safe and useful. However, the MPSH procedure took longer to perform. While there were no significant differences in pain levels between the two groups on days 3 and 14 after surgery, patients who had the MMH surgery experienced more severe pain on day 7. There were also no significant differences in post-surgery bleeding, blood loss during surgery, or development of anal narrowing.

However, patients who had the MPSH surgery were less likely to have their hemorrhoids return within 24 months. Therefore, the researchers concluded that the MPSH procedure may be a better option, despite taking longer to perform. They also suggested that more studies are needed to confirm these findings.

FAQs

  1. What were the two types of surgeries for severe hemorrhoids compared in this study?
  2. Were there any significant differences in pain levels, post-surgery bleeding, blood loss during surgery, or development of anal narrowing between the two types of surgeries?
  3. Which surgical procedure is less likely to have hemorrhoids return within 24 months?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hemorrhoidectomy is to discuss with their healthcare provider the different surgical options available and to consider the potential benefits and risks of each procedure before making a decision. It is important to follow post-operative care instructions carefully, including taking prescribed pain medications, eating a high-fiber diet, staying hydrated, and avoiding straining during bowel movements to promote healing and prevent complications. Additionally, maintaining good hygiene in the anal area and avoiding heavy lifting or strenuous activities can also aid in a smoother recovery process.

Suitable For

Patients with severe hemorrhoids that have not responded to conservative treatments such as dietary changes, topical medications, and banding procedures are typically recommended for hemorrhoidectomy. Additionally, patients who experience chronic pain, bleeding, and discomfort due to their hemorrhoids may also be candidates for surgery. In cases where hemorrhoids are causing significant symptoms and impacting quality of life, a hemorrhoidectomy may be recommended by a healthcare provider.

Timeline

Before hemorrhoidectomy:

  1. Patient experiences symptoms of hemorrhoids such as itching, pain, bleeding, and swelling.
  2. Patient may try conservative treatments such as over-the-counter creams, sitz baths, and dietary changes.
  3. If conservative treatments are not effective, patient may consult with a doctor who may recommend surgical intervention.

After hemorrhoidectomy:

  1. Patient undergoes either modified Park’s submucosal hemorrhoidectomy (MPSH) or Milligan-Morgan hemorrhoidectomy (MMH) surgery.
  2. Patient experiences pain and discomfort in the immediate post-operative period.
  3. Patient may require pain medication and sitz baths to manage pain and promote healing.
  4. Patient may experience some bleeding and discharge in the days following surgery.
  5. Patient gradually recovers and resumes normal activities within a few weeks.
  6. Long-term follow-up shows the effectiveness of the surgery in reducing symptoms and preventing recurrence of hemorrhoids.

What to Ask Your Doctor

  1. What are the different types of hemorrhoidectomy procedures available and which one do you recommend for my condition?
  2. What are the risks and potential complications associated with hemorrhoidectomy surgery?
  3. How long is the recovery period after hemorrhoidectomy surgery and what can I expect in terms of pain and discomfort?
  4. Will I need to make any changes to my diet or lifestyle before or after the surgery?
  5. How successful is hemorrhoidectomy surgery in treating severe hemorrhoids in the long term?
  6. Are there any alternative treatments or procedures that I should consider before undergoing hemorrhoidectomy surgery?
  7. How many of these procedures have you performed and what is your success rate?
  8. Will I need to stay in the hospital after the surgery or is it an outpatient procedure?
  9. How soon after the surgery can I return to work and resume normal activities?
  10. What follow-up care will be needed after the surgery and how often will I need to see you for check-ups?

Reference

Authors: Song X, Sun W, Bao Y, Tu J, Zhang T. Journal: Asian J Surg. 2022 Nov;45(11):2208-2213. doi: 10.1016/j.asjsur.2021.11.032. Epub 2021 Nov 25. PMID: 34840045