The Effect of Different Surgical Techniques of Haemorrhoidectomy on the Occurrence of Postoperative Hypertrophic Anal Papillae.

Abstract

Objective: To explore the differences in the occurrence of postoperative hypertrophic anal papillae (HAP) using different surgical techniques (Ferguson haemorrhoidectomy or Milligan-Morgan haemorrhoidectomy), and whether the haemorrhoidectomy technique is an independent risk factor of postoperative HAP.

Study design: A descriptive study. Place and Duration of the Study: The First Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi, China, from October 2018 to 2023.

Methodology: Data were collected retrospectively from the electronic inpatient and outpatient records of patients with haemorrhoidectomy who were grouped according to the specific haemorrhoidectomy technique, and the difference in the incidence rate of postoperative HAP between the two groups was compared by χ2 test. In addition, the correlation between other observation indicators and postoperative HAP was tested. Relevant indicators were included in binary logistic regression analysis to determine whether the haemorrhoidectomy technique was an independent risk factor for postoperative HAP.

Results: This study collected 815 cases with 494 Milligan-Morgan surgery and 321 Ferguson surgery. Twenty-six (8.1%) cases with Ferguson surgery and 13.16% cases with Miligan-Morgan surgery (n = 65) had postoperative HAP. The difference between the two groups is statistically significant (p = 0.025). After multivariate regression analysis, it was found that the haemorrhoidectomy technique was an independent risk factor of postoperative HAP (p = 0.004).

Conclusion: The frequency of postoperative HAP varies significantly between Milligan-Morgan haemorrhoidectomy and Ferguson haemorrhoidectomy, and the haemorrhoidectomy technique can independently affect the occurrence of postoperative HAP. In order to get a lower occurrence of postoperative HAP, it was recommended for front-line colorectal doctors to consider the Ferguson haemorrhoidectomy.

Key words: Ferguson haemorrhoidectomy, Milligan-Morgan haemorrhoidectomy, Mixed haemorrhoids, Hypertrophic anal papillae, Independent risk factor.