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Open versus closed day-case haemorrhoidectomy: is there any difference? Results of a prospective randomised study.
Int J Colorectal Dis. 2004 Jul; 19(4):370-3.IJ

Abstract

BACKGROUND AND AIMS

Nowadays there is still controversy as to whether open or closed haemorrhoidectomy is the surgical treatment of choice for haemorrhoidal pathology.

PATIENTS AND METHODS

We carried out a randomised prospective study in the Day Surgery Unit comparing 100 patients undergoing Milligan-Morgan haemorrhoidectomy (group A) versus 100 patients undergoing Ferguson haemorrhoidectomy (group B) for symptomatic haemorrhoids, in whom medical treatment or rubber band ligation had failed.

RESULTS

Characteristics of the population were: mean age 43.5 years, with predominance of males, 123 vs. 77; 88% ASA I-II.

CLINICAL PRESENTATION

95% rectal bleeding; 87.5% third-fourth degree. The anaesthetic technique of choice was local anaesthesia plus sedation in 180 patients (90%). Length of surgery: 24 min (group A) and 30 min (group B) (p=n.s.). Resection of three haemorrhoidal cushions was done in 87.5% of cases. There were no re-operations or re-admissions after discharge. Symptomatic recurrence, stenosis and incontinence were not found during the follow-up of the first year. Postoperative pain during the first postoperative week was greater in the open haemorrhoidectomy group, but the difference was statistically significant (p<0.05) only during bowel movements. There was complete healing in 40% of the patients in group A and 90% of those in group B (p<0.05) after 1 month. After 1 year, the results and complications were similar in both groups (p=n.s.).

CONCLUSIONS

Closed haemorrhoidectomy gives better results in terms of pain and healing than open haemorrhoidectomy, whereas recurrence and complications are similar after 1 year.

Authors+Show Affiliations

Coloproctology Unit, Department of Surgery, University Hospital of Elche, C/Huertos y Molinos s/n. C.P., 03203 Elche (Alicante), Spain. arroyocir@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

15170517

Citation

Arroyo, A, et al. "Open Versus Closed Day-case Haemorrhoidectomy: Is There Any Difference? Results of a Prospective Randomised Study." International Journal of Colorectal Disease, vol. 19, no. 4, 2004, pp. 370-3.
Arroyo A, Pérez F, Miranda E, et al. Open versus closed day-case haemorrhoidectomy: is there any difference? Results of a prospective randomised study. Int J Colorectal Dis. 2004;19(4):370-3.
Arroyo, A., Pérez, F., Miranda, E., Serrano, P., Candela, F., Lacueva, J., Hernández, H., & Calpena, R. (2004). Open versus closed day-case haemorrhoidectomy: is there any difference? Results of a prospective randomised study. International Journal of Colorectal Disease, 19(4), 370-3.
Arroyo A, et al. Open Versus Closed Day-case Haemorrhoidectomy: Is There Any Difference? Results of a Prospective Randomised Study. Int J Colorectal Dis. 2004;19(4):370-3. PubMed PMID: 15170517.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Open versus closed day-case haemorrhoidectomy: is there any difference? Results of a prospective randomised study. AU - Arroyo,A, AU - Pérez,F, AU - Miranda,E, AU - Serrano,P, AU - Candela,F, AU - Lacueva,J, AU - Hernández,H, AU - Calpena,R, Y1 - 2004/03/25/ PY - 2003/12/04/accepted PY - 2004/6/2/pubmed PY - 2004/12/16/medline PY - 2004/6/2/entrez SP - 370 EP - 3 JF - International journal of colorectal disease JO - Int J Colorectal Dis VL - 19 IS - 4 N2 - BACKGROUND AND AIMS: Nowadays there is still controversy as to whether open or closed haemorrhoidectomy is the surgical treatment of choice for haemorrhoidal pathology. PATIENTS AND METHODS: We carried out a randomised prospective study in the Day Surgery Unit comparing 100 patients undergoing Milligan-Morgan haemorrhoidectomy (group A) versus 100 patients undergoing Ferguson haemorrhoidectomy (group B) for symptomatic haemorrhoids, in whom medical treatment or rubber band ligation had failed. RESULTS: Characteristics of the population were: mean age 43.5 years, with predominance of males, 123 vs. 77; 88% ASA I-II. CLINICAL PRESENTATION: 95% rectal bleeding; 87.5% third-fourth degree. The anaesthetic technique of choice was local anaesthesia plus sedation in 180 patients (90%). Length of surgery: 24 min (group A) and 30 min (group B) (p=n.s.). Resection of three haemorrhoidal cushions was done in 87.5% of cases. There were no re-operations or re-admissions after discharge. Symptomatic recurrence, stenosis and incontinence were not found during the follow-up of the first year. Postoperative pain during the first postoperative week was greater in the open haemorrhoidectomy group, but the difference was statistically significant (p<0.05) only during bowel movements. There was complete healing in 40% of the patients in group A and 90% of those in group B (p<0.05) after 1 month. After 1 year, the results and complications were similar in both groups (p=n.s.). CONCLUSIONS: Closed haemorrhoidectomy gives better results in terms of pain and healing than open haemorrhoidectomy, whereas recurrence and complications are similar after 1 year. SN - 0179-1958 UR - https://www.unboundmedicine.com/medline/citation/15170517/Open_versus_closed_day_case_haemorrhoidectomy:_is_there_any_difference_Results_of_a_prospective_randomised_study_ L2 - https://doi.org/10.1007/s00384-003-0573-1 DB - PRIME DP - Unbound Medicine ER -