Hemorrhoidectomy : Open Versus Closed Technique at Mahasarakham Hospital
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Abstract
Background: Hemorrhoid was common diseases in elderly age. Open and Closed technique Hemorrhoidectomy was common in the worldwide.
Objective: The aim of this study compared closed (Ferguson) hemorrhoidectomy to open (Milligan-Morgan) regarding postoperative conditions, complications, and long-term results.
Methods: This was a randomized retrospective study of 50 patients with 3-degree or 4-degree hemorrhoids suitable for hemorrhoidectomy in Mahasarakham Hospital, since 1 August 2009 to 31 August 2011. In 25 patients had open hemorrhoidectomy, and in 25 patients had closed hemorrhoidectomy. Operative time, length of hospital stay, wound healing time and postoperative complications were recorded. Pain was assessed by visual analog scale. Follow-up was done at 2 weeks, 4 weeks, and 3 month. T-test analysis was used.
Results: Statistically significant differences were found good outcome in closed hemorrhoidectomy regarding in 48 hours post-operative pain (p<0.01), wound healing time (p<0.01) and mild-moderate hemorrhage complications (p<0.01). No statistically significant difference was found between the two methods regarding operative time (p>0.01), length of hospital stay (p>0.01), postoperative pain in 24 hours (p>0.01) and severe hemorrhage (p>0.01), anal stricture and fecal incontinence complications (p>0.01).
Conclusion: Closed hemorrhoidectomy efficient treatment for hemorrhoids. The closed method has advantage in lower postoperative pain in 48 hours, and faster wound heal, and lower mild to moderate bleeding.
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References
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