PURPOSE: PURPOSE:The aim of this study was to compare closed (Ferguson) hemorrhoidectomy to open (Milligan-Morgan) hemorrhoidectomy regarding postoperative conditions, complications, and long-term results.
METHOD: METHOD:This was a randomized study of 77 patients with second-degree or third-degree hemorrhoids suitable for hemorrhoidectomy. In 39 patients the Milligan-Morgan procedure was used, and in 38 patients the Ferguson procedure was used. Details of operations, postoperative complications, and length of postoperative stay were recorded. Pain was assessed from a visual analog scale and by registration of postoperative analgesic medication. Follow-up was done at three weeks, six weeks, and by visit or telephone interview after at least a year.
RESULTS: RESULTS:No statistically significant differences were found between the two methods regarding complications, pain, or postoperative stay. There were four reoperations for bleeding, all after Milligan-Morgan operations. At follow-up after three weeks 86 percent of the Ferguson patients had completely healed wounds, and none had signs of infection. Of the Milligan-Morgan patients, only 18 percent had completely healed wounds, and symptoms of delayed wound healing were significantly more frequent. One patient had a superficial wound infection. After one year more than 10 percent in each group had recurrent hemorrhoids with symptoms.
CONCLUSION: CONCLUSION:Both methods are fairly efficient treatment for hemorrhoids, without serious draw-backs. The closed method has no advantage in postoperative pain reduction, but wounds heal faster, and the risk of wound dehiscence seems exaggerated.
© The ASCRS 2000