[Submucosal hemorrhoidectomy with Parks technique: prospective study of 327 patients]

Hemorrhoidectomy is the treatment of choice for Stage 3 and 4 hemorrhoids; the most popular technique is that described by Milligan et al. Longo has recently introduced stapled anopexy as an alternative to the Milligan hemorrhoidectomy, however long-term results do not yet demonstrate a convincing superiority. The Parks technique of hemorrhoidectomy is another alternative to Milligan's procedure; it is an established and widely known procedure. The present prospective trial reports the immediate and medium-term results of Parks hemorrhoidectomy performed on 327 consecutive patients between 1997 and 2001. All patients were interviewed using a standard questionnaire before surgery and at 1 and 3 weeks after surgery. An anal incontinence score was recorded before and after surgery in the first 198 patients. No serious operative complications were seen. The daily mean postoperative pain score was less than 3. Mean hospital stay was 2.2 days and work incapacity was 11 days. The anal incontinence score was unchanged or improved in 179 patients (90.4%) and was worsened in 19 patients (9.6%). This trial confirms that Parks hemorrhoidectomy is safe and leads to satisfactory outcome. Postoperative pain is reduced and anal functional sequelae are few.