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Open and closed haemorrhoidectomy for fourth degree haemorrhoids--comparative one center study
1Department of General and Colorectal Surgery of Medical University in Lodz.
Aim:
We compared results of two techniques of haemorrhoidectomy: open Milligan-Morgan (MM) and closed Ferguson (CF) techniques. Length of hospitalization, pain complaints, return to full activity, wound healing time were considered.
Methods:
We included the group of 63 patients: 29 patients (16 women) were randomly allocated to MM operation and 34 patients (15 women) to CF operation. Follow-up study was performed after 2, 4, 24 weeks and six and eighteen months postoperatively.
Results:
We did not note any statistically significant differences in relation to hospitalization time 30.9 days (MM) and 30.8 days (CF). Postoperative urine retention was similar: 5 (17.2%) patients (MM) and 7 (20.6%) patients (CF). No differences in the intensity of postoperative pain was observed. Patients returned to work after 293 days (MM) and 342 days (CF) (p = 0.059). We observed no infection of the wound in MM group but in four patients from CF group (11.8%); (p = 0.053). However overall wound healing time was shorter after CF method than after MM method: 233 vs. 274 days, respectively (p = 0.053).
Conclusions:
Our study confirms that the results after MM and CF haemorrhoidectomy are similar. We found a trend towards faster wound healing after CF procedure, however there was a trend towards higher wound infection in that group. There was also a trend towards shorter recovery time in patients after MM operation.
