Khawar Rafiq, P D Scott.
Closed Versus Open Hemorrhoidectomy Little to choose between two techniques.
Ann King Edward Med Uni Jan ;7(1):6-7.

The purpose of this study was to compare the closed (Ferguson) haemorrhoidectomy to open (Milligan-Morgan) hemorrhoidectomy regarding post operative conditions, complications and long term results. From June 1997 to June 1998, fifty-five patients with second degree or third degree haemorrhoids were treated with; haemorrhoidectomy at Burnley General Hospital U.K. In 30 patients closed method was used and in 25 patients open method was used. Details of operations, post operative complications and length of post operative stay were recorded. Follow up was done in 3 weeks, 6 weeks, 3 months, 6 months and 1 year. No significant difference was found between two methods regarding pain scores, analgesia requirements and hospital stay. Follow up after 3 weeks, 70 percent after closed hemorrhoidectomy had completely healed wounds whereas 15 percent with open haemorrhoidectomy had completely healed wounds. Incidence of prolonged serous discharge was more in unhealed closed wounds whereas pruritis and granuloma were high in open wounds. Urinary disturbances were similar in both groups. The normal bowel habit was established earlier in open method. After one year more than 8 percent in each group had recurrent symptomatic haemorrhoids. Both methods are fairly efficient treatment for haemorrhoids. Closed method leads to faster healing but the risk of wound dehiscence seem exaggerated and there is no pain reduction.

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