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Randomized clinical trial of the effects on anal function of Milligan-Morgan versus Ferguson haemorrhoidectomy.
Br J Surg. 2006 Oct; 93(10):1208-14.BJ

Abstract

BACKGROUND

Studies of haemorrhoidectomy usually report postoperative pain, healing and complications, but rarely consider anal function in the longer term. The primary aim of this randomized trial was to compare long-term changes in anal function after open (Milligan-Morgan) and closed (Ferguson) haemorrhoidectomy.

METHODS

A total of 225 patients were included in the trial, 115 in the open group and 110 in the closed group. Continence changes were recorded by means of validated questions and an incontinence score. Pain was self-reported using a visual analogue scale.

RESULTS

Postoperative pain and complications did not differ between the groups. Time to recovery was 17 days in the Milligan-Morgan group and 15 days in the Ferguson group. After 1 month the wounds were healed in 57.0 per cent of patients in the open group and 70.6 per cent of those in the closed group (P = 0.058). At 1 year, 78.9 per cent of the Milligan-Morgan group and 85.3 per cent of the Ferguson group reported no continence disturbance (P = 0.072). The incontinence score was improved at 1 year in the closed group (P = 0.015), but was unchanged in the open group (P = 0.645). Patients who had the Ferguson procedure were more satisfied with the outcome of surgery (P = 0.047).

CONCLUSION

Closed Ferguson haemorrhoidectomy was superior to the open Milligan-Morgan procedure with respect to long-term anal continence and patient satisfaction.

Authors+Show Affiliations

Department of Surgery, Falun Hospital, Falun, Sweden. helgi-orn.johannsson@ltdalarna.seNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16952213

Citation

Jóhannsson, H O., et al. "Randomized Clinical Trial of the Effects On Anal Function of Milligan-Morgan Versus Ferguson Haemorrhoidectomy." The British Journal of Surgery, vol. 93, no. 10, 2006, pp. 1208-14.
Jóhannsson HO, Påhlman L, Graf W. Randomized clinical trial of the effects on anal function of Milligan-Morgan versus Ferguson haemorrhoidectomy. Br J Surg. 2006;93(10):1208-14.
Jóhannsson, H. O., Påhlman, L., & Graf, W. (2006). Randomized clinical trial of the effects on anal function of Milligan-Morgan versus Ferguson haemorrhoidectomy. The British Journal of Surgery, 93(10), 1208-14.
Jóhannsson HO, Påhlman L, Graf W. Randomized Clinical Trial of the Effects On Anal Function of Milligan-Morgan Versus Ferguson Haemorrhoidectomy. Br J Surg. 2006;93(10):1208-14. PubMed PMID: 16952213.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Randomized clinical trial of the effects on anal function of Milligan-Morgan versus Ferguson haemorrhoidectomy. AU - Jóhannsson,H O, AU - Påhlman,L, AU - Graf,W, PY - 2006/9/5/pubmed PY - 2006/11/2/medline PY - 2006/9/5/entrez SP - 1208 EP - 14 JF - The British journal of surgery JO - Br J Surg VL - 93 IS - 10 N2 - BACKGROUND: Studies of haemorrhoidectomy usually report postoperative pain, healing and complications, but rarely consider anal function in the longer term. The primary aim of this randomized trial was to compare long-term changes in anal function after open (Milligan-Morgan) and closed (Ferguson) haemorrhoidectomy. METHODS: A total of 225 patients were included in the trial, 115 in the open group and 110 in the closed group. Continence changes were recorded by means of validated questions and an incontinence score. Pain was self-reported using a visual analogue scale. RESULTS: Postoperative pain and complications did not differ between the groups. Time to recovery was 17 days in the Milligan-Morgan group and 15 days in the Ferguson group. After 1 month the wounds were healed in 57.0 per cent of patients in the open group and 70.6 per cent of those in the closed group (P = 0.058). At 1 year, 78.9 per cent of the Milligan-Morgan group and 85.3 per cent of the Ferguson group reported no continence disturbance (P = 0.072). The incontinence score was improved at 1 year in the closed group (P = 0.015), but was unchanged in the open group (P = 0.645). Patients who had the Ferguson procedure were more satisfied with the outcome of surgery (P = 0.047). CONCLUSION: Closed Ferguson haemorrhoidectomy was superior to the open Milligan-Morgan procedure with respect to long-term anal continence and patient satisfaction. SN - 0007-1323 UR - https://www.unboundmedicine.com/medline/citation/16952213/Randomized_clinical_trial_of_the_effects_on_anal_function_of_Milligan_Morgan_versus_Ferguson_haemorrhoidectomy_ L2 - https://doi.org/10.1002/bjs.5408 DB - PRIME DP - Unbound Medicine ER -