Effects of modified Milligan-Morgan hemorrhoidectomy with acupuncture on postoperative wound healing and pain in mixed hemorrhoids

doi:10.4240/wjgs.v18.i7.120492

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Cohort Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Jul 27, 2026; 18(7): 120492
Published online Jul 27, 2026. doi: 10.4240/wjgs.v18.i7.120492

Effects of modified Milligan-Morgan hemorrhoidectomy with acupuncture on postoperative wound healing and pain in mixed hemorrhoids

Yong-Jiao Zhao, Qian-Yu Xu, Ying Shi, Wei-Na Guo

Yong-Jiao Zhao, Department of Anorectal Surgery, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 101100, China

Qian-Yu Xu, Department of Traditional Chinese Medicine, Taikang Tongji (Wuhan) Hospital, Wuhan 430000, Hubei Province, China

Ying Shi, Department of Rehabilitation Medicine, Jiangqiao Town Community Health Service Center, Shanghai 201800, China

Wei-Na Guo, Department of Medical Affairs, Jiangqiao Town Community Health Service Center, Shanghai 201803, China

Co-first authors: Yong-Jiao Zhao and Qian-Yu Xu.

Author contributions: Zhao YJ and Xu QY contributed equally to this article, they are the co-first authors of this manuscript; Zhao YJ, Xu QY, and Shi Y contributed to research design, data collection, data analysis, and paper writing; Guo WN was responsible for research design, funding application, data analysis, reviewing and editing, communication coordination, ethical review, copyright and licensing, and follow-up; and all authors thoroughly reviewed and endorsed the final manuscript.

Institutional review board statement: This study was approved by the Medical Ethics Committee of the Jiading Branch of Shanghai General Hospital, approval No. [2025] 019.

Informed consent statement: All research participants or their legal guardians provided written informed consent prior to study registration.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: No other data available.

Corresponding author: Wei-Na Guo, Associate Chief Physician, Department of Medical Affairs, Jiangqiao Town Community Health Service Center, No. 100 Jinyao Road, Jiading Distirct, Shanghai 201803, China. drweinaguo@163.com

Received: February 27, 2026
Revised: March 20, 2026
Accepted: May 9, 2026
Published online: July 27, 2026
Processing time: 150 Days and 1.8 Hours

Abstract

BACKGROUND

Post-hemorrhoidectomy pain and delayed wound healing remain major clinical challenges for grade III-IV mixed hemorrhoids, limiting patient recovery and quality of life. Conventional care has limited efficacy in mitigating these issues. Acupuncture, a traditional Chinese medicine therapy, exhibits analgesic and anti-inflammatory properties. This study hypothesizes that modified Milligan-Morgan hemorrhoidectomy (M-MMH) combined with acupuncture can alleviate postoperative pain, accelerate wound healing, and reduce complications in these patients.

AIM

To investigate whether combining M-MMH with acupuncture reduces postoperative pain and accelerates wound healing in mixed hemorrhoid patients.

METHODS

This single-center retrospective cohort study analyzed 80 patients from January 2023 to December 2024. Patients were assigned to combined group (n = 40, received postoperative acupuncture) or control group (n = 40, surgery alone) based on actual treatment. Acupuncture (Changqiang, Chengshan, Erbai) started 6h post-surgery, once daily for 7 days. Pain (visual analog scale), wound edema, exudate, granulation scores, healing times, and complications were compared using t-tests, χ² tests, and Bonferroni correction.

RESULTS

The combined group had considerably lower visual analog scale scores than the control group at all time points (P < 0.05). The combined group had significantly lower scores for trabecular edema, exudate, and granulomatous dysplasia than the control group on postoperative days 3 and days 7 (P < 0.001). The time for the disappearance of wound secretions, the time for the disappearance of edema, and the healing time were considerably shorter in the combined group when compared with the control group (P < 0.001). The overall incidence of postoperative complications in the combined group (10.0%) was considerably lower than that in the control group (27.5%).

CONCLUSION

Modified M-MMH combined with acupuncture is associated with observed correlations of reduced postoperative pain, accelerated wound healing, and lower complication rates with mixed hemorrhoids, rather than definitive causal effects.

Keywords: Modified Milligan-Morgan hemorrhoidectomy; Acupuncture therapy; Mixed hemorrhoids; Pain; Wound healing

Core Tip: This study demonstrates that combining modified Milligan-Morgan hemorrhoidectomy (M-MMH) - featuring “V”-shaped incisions and figure-of-eight ligation - with early postoperative acupuncture significantly accelerates wound healing and reduces pain in patients with grade III-IV mixed hemorrhoids. The adjunctive acupuncture protocol targeting Changqiang (GV1), Chengshan (BL57), and Erbai markedly lowered visual analog scale scores, shortened edema and exudate resolution times, and reduced overall complications compared to M-MMH alone. This integrative approach offers a safe, effective strategy for enhanced recovery after hemorrhoid surgery.