Long-term functional results after excisional haemorrhoidectomy.

Area of Science:

• Colorectal Surgery
• Surgical Outcomes
• Patient-Reported Outcomes

Background:

• Hemorrhoidectomy is a common surgical procedure.
• Long-term functional outcomes after hemorrhoidectomy require further evaluation.
• Randomized trials provide valuable data on surgical interventions.

Purpose of the Study:

• To conduct a long-term evaluation of a randomized trial on functional aspects after excisional hemorrhoidectomy.
• To assess patient-reported outcomes with a minimum follow-up of 9 years.
• To compare functional results between Milligan's and Ferguson's hemorrhoidectomy techniques.

Main Methods:

• A questionnaire-based study of patients undergoing hemorrhoidectomy between 1999-2003 in Sweden.
• Randomization of 225 patients to either Milligan's or Ferguson's operation.
• Analysis of data from 151 patients (76% participation) after a median follow-up of 10.7 years.

Main Results:

• Reduced prevalence of anal bleeding (80% to 28%), anal pain (49% to 17%), and soiling (51% to 20%) at long-term follow-up.
• Significant decrease in pad usage (19% to 6%) and straining during defecation (35% to 25%).
• Perceived recurrence reported by 32% of patients, and 19% experienced a sense of anal stenosis.

Conclusions:

• Excisional hemorrhoidectomy leads to significant long-term improvement in symptoms.
• The most frequent long-term issues reported were recurrence and anal stenosis.
• Functional outcomes suggest a favorable long-term result for both surgical techniques.