Haemorrhoidectomy: Ferguson's (closed) vs Milligan Morgan's technique (open)

Area of Science:

• Colorectal Surgery
• Surgical Techniques
• Hemorrhoid Treatment

Background:

• Hemorrhoids are a common condition affecting a significant portion of the population.
• Surgical intervention, including open and closed haemorrhoidectomy, is a primary treatment for advanced hemorrhoids.
• Choosing the optimal surgical technique is crucial for minimizing patient discomfort and improving outcomes.

Purpose of the Study:

• To compare the efficacy of closed versus open haemorrhoidectomy.
• To evaluate postoperative pain as the primary outcome measure.
• To assess other relevant surgical outcomes such as operation time and blood loss.

Main Methods:

• An unblinded randomized controlled trial was conducted with 56 patients.
• Patients had third and fourth-degree hemorrhoids.
• Postoperative pain was measured using a visual analogue scale.

Main Results:

• Operation time was shorter for the open technique (200 seconds/cushion) compared to the closed technique (626 seconds/cushion).
• Blood loss was not quantifiable in the closed technique group.
• Immediate postoperative pain scores were significantly lower in the closed group (4.9) versus the open group (7.8).
• Pain scores at 24 hours were also significantly lower in the closed group (2.3) compared to the open group (6.9).

Conclusions:

• Closed haemorrhoidectomy demonstrates significant advantages over the open technique, primarily due to reduced postoperative pain.
• The closed technique offers a potentially less painful recovery for patients undergoing hemorrhoid surgery.
• Further research may explore long-term outcomes and patient satisfaction for both techniques.