PPH en Europa Continental. 15th Annual Colorectal Disease Symposium, Cleveland Clinic Florida-13/02/2004
“PPH for Hemorrhoids in Europe,an Update 1999-2003”
Thorolf Hager, MD
PPH for hemorrhoids is a well accepted methode in Europe. About 200000
cases are expected to be operated since 1999. There is great number of publications
on this technique ,including randomised controlled studies : PPH versus Milligan-
Morgan Procedure. Also the number of cases is rather small, they show a significant
better short time result versus Milligan Morgan.
But there are also reports on severe complications like recto.vag. fistulas,rectal
perforation,Fournier-Gangren, but the number is very low: 1.2 pro mill.
The all over rate of post.op. complications is 5%, which is lower than in Milligan
In summary PPH represents in the hand of the well trained surgeon a save methode
to treat prolapsing hemorrhoids 3°. This methode leads to a shorter reconvalescence,
LOS is short, there is less pain, the time back to work is shorter, all these results are
signicant better to Milligan Morgam Procedure.