Clinical observation on treatment of mixed hemorrhoids with milligan morgan hemorrhoidectomy combined with purse-string suture

Objective: To compare the efficacy of traditional Milligan Morgan hemorrhoidectomy (MMH) and its combination with purse-string suture for treating mixed hemorrhoids, and to evaluate the clinical significance of the latter. Methods: A total of 102 patients with mixed hemorrhoids who were admitted to Anorectal Surgery Department of Affiliated Hospital of Beihua University from January 2016 to January 2018 were randomized into three surgical groups (n=34 per group): traditional surgery group, procedure for prolapse and hemorrhoids (PPH group), and traditional hemorrhoidectomy combined with purse suture (combined surgery group). The surgery completion time, healing time, post-operative duration of hospitalization, postoperative pain, postoperative complications, and clinical efficacy were observed. Results: There was no significant difference in the operative times among the three groups (P>0.05). The postoperative healing time was the shortest in the combined surgery group (P<0.05), followed by the PPH group, and the traditional surgery group had the longest healing time. The duration of hospitalization of the combined surgery group was also significantly shorter compared to both traditional surgery and PPH groups (both P<0.05). The 24 h post-operation, first defecation, and 7 days' post-operation pain scores were all significantly higher in the traditional surgery group compared to the PPH and combined surgery groups (all P<0.05), and the first defecation pain score in the PPH group was higher than that in the combined surgery group. The incidence of postoperative hemorrhage in the traditional surgery group was significantly higher compared to the other two groups. The incidence of dysuria was significantly lower in the combined surgery group compared to the traditional surgery and PPH groups. The incidences of perianal edema and anal pendant expansion were significantly higher in the traditional surgery group compared to the PPH and the combined surgery groups (both P<0.05). There were no significant differences in anal stenosis, difficult defecation and anal prolapse among the three groups (all P>0.05). The clinical efficacy of the combined surgery group was better than that of the traditional surgery group (P<0.05). Conclusion: MMH combined with purse-string suture can shorten wound healing time, relieve postoperative pain, reduce postoperative complications, and improve clinical efficacy for the treatment of mixed hemorrhoids, and therefore is worthy of further clinical application.