A COMPARATIVE STUDY OF OPEN (MILLIGAN – MORGAN) VERSUS CLOSED (FERGUSON) HEMORRHOIDECTOMY: A TERTIARY CARE CENTRE EXPERIENCE OF AMRAVATI, MAHARASHTRA.

Dr Narendra Wankhade, Dr Yogendra P Chidrawar

Abstract


Background: Hemorrhoidectomy is the treatment of choice for patients with third-degree or fourth-degree
haemorrhoids. This prospective randomized clinical study compared the outcome of surgical haemorrhoidectomy by
open and closed techniques in terms of postoperative pain, wound healing, and morbidity.
Methods: This prospective randomized clinical study was conducted during the period January 2018 to June 2019 in Dr.
Panjabrao Deshmukh memorial medical college. All consecutive patients with Grade III internal haemorrhoids or
Grade IV haemorrhoids were randomly allocated to one of two groups.
Results: There were 50 patients in each group. No statistically significant differences were found between the two
methods regarding complications, pain, or postoperative stay. There were 3 reoperations for bleeding, all after Milligan-
Morgan operations. At follow-up after three weeks 76 percent of the Ferguson patients had completely healed wounds,
and none had signs of infection. Of the Milligan-Morgan patients, only 24 percent had completely healed wounds, and
symptoms of delayed wound healing were significantly more frequent..
Conclusion: Both methods are fairly efficient treatment for third and fourth degree hemorrhoids, without serious
drawbacks. The closed method has no advantage in postoperative pain reduction but is more advantageous with respect
to faster wound healing


Keywords


Closed hemorrhoidectomy, Haemorrhoids, Open hemorrhoidectomy.

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