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Randomized clinical trial of the effects on anal function of Milligan-Morgan versus Ferguson haemorrhoidectomy
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Center for Clinical Research Dalarna.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences. (Gastrointestinal Surgery)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences. (Gastrointestinal Surgery)
2006 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 93, no 10, 1208-1214 p.Article in journal (Refereed) Published
Abstract [en]

Background: Studies of haemorrhoidectomy usually report postoperative pain, healing and complications, but rarely consider anal function in the longer term. The primary aim of this randomized trial was to compare long-term changes in anal function after open (Milligan-Morgan) and closed (Ferguson) haemorrhoidectomy.

Methods: A total of 225 patients were included in the trial, 115 in the open group and 110 in the closed group. Continence changes were recorded by means of validated questions and an incontinence score. Pain was self-reported using a visual analogue scale.

Results: Postoperative pain and complications did not differ between the groups. Time to recovery was 17 days in the Milligan-Morgan group and 15 days in the Ferguson group. After 1 month the wounds were healed in 57.0 per cent of patients in the open group and 70.6 per cent of those in the closed group (P = 0.058). At 1 year, 78.9 per cent of the Milligan-Morgan group and 85.3 per cent of the Ferguson group reported no continence disturbance (P = 0.072). The incontinence score was improved at 1 year in the closed group (P = 0.015), but was unchanged in the open group (P = 0.645). Patients who had the Ferguson procedure were more satisfied with the outcome of surgery (P = 0.047).

Conclusion: Closed Ferguson haemorrhoidectomy was superior to the open Milligan-Morgan procedure with respect to long-term anal continence and patient satisfaction.

Place, publisher, year, edition, pages
2006. Vol. 93, no 10, 1208-1214 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-19201DOI: 10.1002/bjs.5408ISI: 000241584900006PubMedID: 16952213OAI: oai:DiVA.org:uu-19201DiVA: diva2:46973
Available from: 2006-11-27 Created: 2006-11-27 Last updated: 2017-12-08Bibliographically approved

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Påhlman, LarsGraf, Wilhelm

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