Open and closed haemorrhoidectomy for fourth degree haemorrhoids - comparative one center study

Abstract

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. 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. 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). 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.