TITLE:
Surgical Treatment of Hemorrhoidal Disease at Brazzaville University Hospital Center
AUTHORS:
Murielle Etiennette Julie Note Madzele, Pierlesky Elion Ossibi, Rody Stéphane Ngami, Didace Massamba Miabaou, Clausina Philestine Mikolele Ahoui Apendi, Noé Henschel Motoula Latou, Bhodeho Medy Monwongui, Giresse Bienvenu Tsouassa Wa Ngono, Prude Pertinie Avala, Carmich Nzaka Moukala, Cédrick Du Bonheur Alima Koya, Blaise Irénée Atipo-Ibara
KEYWORDS:
Hemorrhoidal Disease, Surgery, Milligan and Morgan
JOURNAL NAME:
Surgical Science,
Vol.15 No.3,
March
29,
2024
ABSTRACT: Introduction: Hemorrhoidal disease is a common pathology and its
surgical treatment is based, among other things, on pedicular resection after
failure of medical and instrumental treatment. The aim of this study is to
analyze the epidemiological, clinical, therapeutic and evolving aspects of
hemorrhoidal disease at the stage of surgical treatment at the University
Hospital Center of Brazzaville. Patients and Methods: We conducted a retrospective and descriptive study
carried out from January 2020 to December 2021, a 24 months period, in the
Digestive surgery department of the University Hospital Center of Brazzaville.
It concerned patients who underwent a surgical procedure for hemorrhoidal
disease. Results: 21 cases were collected, representing a hospital frequency of 2.3%, with
a sex ratio of 4.3 in favor of men. The average age of patients was 42.2 ± 11.9
years. The symptoms were mainly proctalgia, mass sensation and rectal bleeding.
We recorded five cases (19.1%) of hemorrhoidal thrombosis and 16 cases (80.9%)
of hemorrhoidal prolapse including 12 cases requiring manual integration
(Goligher grade III) and four irreducible permanent cases (Goligher grade IV).
The Grade III prolapse was associated with a polyp in one patient and with
posterior anal fissure in another patient. Out of the 21 patients, 14 underwent
a tripedicular hemorrhoidectomy according to Milligan and Morgan. Two patients
underwent mono- and bipedicular hemorrhoidectomy with resection of associated
lesions and five patients underwent emergency thrombectomy. The outcome was
favorable for all our patients. The average length of hospital stay was 1.5 ±
2.1 days. Conclusion: In the event of failure of medical and instrumental
treatment, the hemorrhoidal cure according to Milligan and Morgan is the
surgical treatment of reference for hemorrhoidal disease at the University
Hospital Center of Brazzaville.