A Meta-analysis On Long Term Efficacy Of PPH Operation And MMH Operation In Treating Mixed Hemorrhoid

Objective To assess the long term efficacy of procedure for prolapse and hemorrhoids(PPH)and milligan-morgan hemorrhoidectomy(MMH)in Treating Mixed Hemorrhoid.(Long-term efficacy was at least 6 months postoperatively).Methods Electronic databases including Wan Fang Data,CNKI,VIP and Pub Med were searched.The date of search was between January 2005 and January 2017.the content of the search was studying association of Compare PPH and MMH treatment.The quality of the included literature was evaluated and then extracting useful data to the Review Manager 5.3 software for meta-analysis.Results A total of 10 articles were included in the study.Among them,the evaluation of PPH group and MMH group treatment of mixed hemorrhoids long-term efficacy of the relevant indicators include blood in the stool,formation of skin tags anal pain,hemorrhoid block prolapse,anal itching,anal incontinence,anal stenosis,anal bulge,recurrence,anal fissure and so on.The results of meta-analysis indicated:compared with MMH,PPH formation of skin tags(OR=0.50,95%CI:0.28~0.89,P=0.02),anal incontinence(RD=-0.03,95%CI:-0.06~-0.01,P=0.02)was lower than MMH,but anus falls(OR=4.72,95%CI:1.74~12.80,P=0.002),anal fissure(OR=4.72,95%CI:1.74~12.80,P=0.002)was higher than MMH.In the blood in the stool,anal pain,hemorrhoid block prolapse,anal stenosis,anal itching,recurrence and other evaluation indicators,there was no significant difference between PPH and MMH(all P> 0.05).Conclusion Compared with MMH,PPH can reduce the incidence of skin lesions,the incidence of anal incontinence,but the the incidence of anal fall,anal fissure were higher than MMH.In the blood in the stool,anal pain,hemorrhoid block prolapse,anal stenosis,anal itching,recurrence and other evaluation indicators,PPH was no significant difference to MMH.Therefore,we believe the two procedures have their own advantages in the long-term effect on postoperative.