TPW 2.03 Postoperative Outcomes Following Open (Milligan–Morgan) Haemorrhoidectomy: A Nine-Year Single-Surgeon Cohort Study
Open (Milligan–Morgan) haemorrhoidectomy is regarded as the gold standard for symptomatic prolapsing haemorrhoids, although newer techniques are increasingly adopted. This study aimed to evaluate complication rates and short-term recurrence following Milligan–Morgan haemorrhoidectomy performed under a standardised protocol by a single surgeon. A retrospective cohort study of 284 consecutive patients undergoing Milligan–Morgan haemorrhoidectomy between December 2015 and December 2024 was performed. Data were extracted from electronic patient records and theatre management systems and independently verified by two clinicians. Patients were routinely reviewed at two weeks and three months postoperatively. Primary outcomes were postoperative complications, including haemorrhage, anorectal sepsis, urinary retention, incontinence and anal stenosis. Secondary outcome was recurrence at three months. Reactionary haemorrhage requiring return to theatre occurred in 2/284 patients (0.70%). Secondary haemorrhage occurred in 9/284 (3.16%). Anorectal sepsis managed conservatively was observed in 20/284 (7.0%), urinary retention in 15/284 (5.28%), transient incontinence in 5/284 (1.76%) and anal stenosis requiring intermittent dilatation in 7/284 (2.46%). Recurrence at three months was identified in 10/284 patients (3.52%). Milligan–Morgan haemorrhoidectomy demonstrates low complication and recurrence rates when performed with appropriate patient selection and meticulous technique. These results support its continued role as a reliable surgical option for symptomatic prolapsing haemorrhoids.