Muhammad Khurram Zia, Muhammad Saad Usman, Alvia Saad, Tariq Mehmood Khan.
Outcome of closed Ferguson’s hemorrhoidectomy vs open Milligan Morgan hemorrhoidectomy.
Pak J Surg Jan ;30(2):128-31.

Objective: To compare the current perioperative and postoperative complications of closed Ferguson’s hemorroidectomy versus open Milligan Morgan hemorrhoidectomy in Abbasi Shaheed Hospital, Karachi. Study Design: Randomized Controlled Trial Sett ing and Duration: Abbasi Shaheed Hospital, Karachi from June 2011 to November 2011. Methodology: Patients admitt ed with 3rd and 4th degree haemorrhoid in which prior medical treatment (high residue diet and warm sitz bath) or rubber band ligation had failed were included. All relevant features including patient bio data, peri and post operative complications like pain, bleeding, urinary retention and wound healing was recorded. Patients were followed up on 1st postoperative day and then weekly for two months in outpatient department and fi nal outcome were measured at the end of two month. Results: A total 112 patients with third and fourth degree hemmorrhoids were admitt ed. Th is comprised of 57 (50.9%) males and 55 (49.1%) females with mean age of 38yrs. Patients were reviewed per-operatively and post-operatively with follow up done on day 1, aft er one week, 2 week, 01 month and 02 months for postoperative complications. Th ere was no peroperative hemorrhoidectomy bleeding. Postoperatively, nearly all the patients presented with bleeding on fi rst day, but aft er fi rst week only fi ve patients who underwent closed ferguson hemorrhoidectomy had bleeding compared to 10 patients in Milligan Morgan which was managed conservatively. Postoperative pain was moderate in intensity in 68 patients on fi rst postoperative day on VA scale and was a litt le more severe in the Milligan Morgan group; no patient had post procedure wound infection. Conclusion: Milligan morgan was associated with a litt le more postoperative complications than Closed Ferguson type. Closed hemorrhoidectomy off ers no advantage regarding postoperative pain, but performed carefully it leads to faster wound healing.

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