Outcome of Pedicular

BACKGROUND: Milligan-Morgan excision haemorrhoidectomy remains a very popular treatment modality for third and fourth degree hemorrhoids due to its cost effectiveness and better long-term results. Ferguson haemorrhoidectomy is believed to result in less postoperative pain because of a closed wound. The aim of this study was to compare the effectiveness of Milligan-Morgan excision haemorrhoidectomy with Ferguson haemorrhoidectomy, METHODS: A prospective clinical trial was conducted. Patients with newly diagnosed hemorrhoids requiring haemorrhoidectomy were randomized to either Milligan-Morgan excision haemorrhoidectomy or Ferguson haemorrhoidectomy. Surgical technique and prospective care was standardized. Outcome measures were operative time and bleeding, postoperative pain (measured on visual analogue scale) and rate of wound healing. RESULTS: We randomized 140 patients, 70 to Milligan-Morgan excision haemorrhoidectomy and 70 to Ferguson haemorrhoidectomy; after taking an informed consent from every individual, 140 patients were evaluated. They were aged between 19 and 71 years. There were no differences in patient demographics or type of hemorrhoid being operated on. Ferguson haemorrhoidectomy had a significantly longer mean operative time and minor problems of bleeding, wound discharge and pruritis. At 3 weeks after surgery, Ferguson haemorrhoidectomy had an odds ratio for complete epithelization of 3.1 over MilliganMorgan excision haemorrhoidectomy. There was less postoperative pain in Ferguson haemorrhoidectomy. CONCLUSION: Ferguson haemorrhoidectomy is superior to Milligan-Morgan excision haemorrhoidectomy.