Ahmed Nurus Sami, Maliha Yunus, Shazia Riaz.
Open Versus Closed Haemorrhoidectomy: Evaluation of Morbidity and Complications.
J Islamic Int Med Coll Jan ;10(2):173-6.

Objective: To compare the outcome of open Milligan-Morgan haemorrhoidectomy (MMH) with that of closed Ferguson haemorrhoidectomy (FH) regarding post operative pain, wound healing and complications. Study Design: Quasi Experimental study design. Place and Duration of Study: The study was conducted from 1st of May 2008 to 31st December 2013 at Islamic International Medical college Hospital Islamabad. Materials and Methods: Forty eight patients suffering from haemorrhoids were divided into two equal groups by consecutive sampling method. In 24 patients (group I) haemorrhoidectomy was done by open method (Milligan-Morgan), and remaining 24 patients (group II) were treated by close method (Ferguson). Outcome in the two groups such as post operative pain, wound healing, anal stenosis and anal incontinence were compared. Results: Post operative pain was less in group-II (close) compared to group-I (open). In group-II pain score on VAS was 4.8 at 8 hours post operatively which subsided to 2.1 at 48 hours, mean score was 2.9. In group-I post operative pain on VAS was 7.2 at 8 hours which came down to 3.8 at 48 hours, mean score was 5.28. Wound healing in group-II (close) took 7 to 12 days, while in group-I (open) it occurred in 15 to 25 days. Post operatively analgesia was required for an average 10 days in group-II, and for 19 days in group-I patients. Anal stenosis and anal incontinence were not noted in either group within 6 months. Conclusion: Close haemorrhoidectomy has shown better outcome compared with open haemorrhoidectomy in terms of post operative pain, analgesic requirement and wound healing. Anal stenosis and anal incontinence are not seen in either group within observation period of 6 months.

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