Dr. Abdul Razaque Shaikh, Department of General Surgery, Liaquat University of Medical Health & Sciences Jamshoro, Sindh, Pakistan.
Dr. Abdul Ghafoor Dalwani, MS, Department of General Surgery, Liaquat University of Medical Health & Sciences Jamshoro, Sindh, Pakistan.
Pak J Med Sci. 2013 Jan;29(1):122-7. doi: 10.12669/pjms.291.2858.
o compare the outcome of Milligan-Morgan (MMH) and Ferguson (FH) techniques for haemorrhoidectomy with regard to postoperative pain, control of bleeding, early mobilization of patients and wound healing.
In this prospective, randomized clinical study conducted between January 2005 to December 2008, 213 patients with late 2(nd) degree; third or fourth degree hemorrhoids were assigned to two groups. One hundred ten patients in group A were operated by an open method and 103 patients in group B were operated by closed method.
Age ranged from 22-70 years with mean age of 45.5 years. Peak incidence was between 41-50 years. Out of 213 patients, 170 (79.81%) were male and 43 (20.18%) were females. The mean ± SD operating time was significantly more in group B (31.3±4.8 min) than group A (25.2±5.6). The duration of hospitalization and duration off from work was more in group A than the group B. Wound healing was quicker in group B than the group A. Post operative pain scores were significantly low in the Group A than Group B during first 24 hours and at first bowel movements. Reactionary hemorrhage occurred in 4 (3.63%) patients of group A, no patient in group B developed this complication. Retention of urine was seen in 13 (11.81%) patients in group A and 4 (3.88%) in group B. No patient in group A developed anal stenosis, while 3 (2.91%) patients in group B developed anal stenosis. Wound infection was one (0.9%) in group A and two (1.9%) in group B. Two (3.63%) patients in group A came with recurrent hemorrhoids and in group B, only one (0.97%) patient reported recurrence.
The closed technique is more beneficial with respect to postoperative pain, control of bleeding, early mobilization of patients and wound healing.
比较痔环切术（MMH）和 Ferguson 手术（FH）治疗痔的术后疼痛、出血控制、患者早期活动和伤口愈合情况。
本前瞻性随机临床研究于 2005 年 1 月至 2008 年 12 月进行，将 213 例晚期 2 度；第 3 或第 4 度痔患者分为两组。A 组 110 例患者采用开放式手术，B 组 103 例患者采用闭合式手术。
年龄 22-70 岁，平均年龄 45.5 岁。发病高峰为 41-50 岁。213 例患者中，男 170 例（79.81%），女 43 例（20.18%）。B 组（31.3±4.8 分钟）的平均手术时间显著长于 A 组（25.2±5.6 分钟）。A 组的住院时间和工作缺勤时间均长于 B 组。B 组的伤口愈合速度快于 A 组。在第 1 天和第 1 次排便时，A 组术后疼痛评分明显低于 B 组。A 组有 4 例（3.63%）患者发生反应性出血，B 组无患者发生此并发症。A 组有 13 例（11.81%）患者发生尿潴留，B 组有 4 例（3.88%）患者发生尿潴留。A 组无患者发生肛门狭窄，B 组有 3 例（2.91%）患者发生肛门狭窄。A 组有 1 例（0.9%）患者发生伤口感染，B 组有 2 例（1.9%）患者发生伤口感染。A 组有 2 例（3.63%）患者出现复发性痔，B 组仅有 1 例（0.97%）患者出现复发。
闭合式手术在术后疼痛、出血控制、患者早期活动和伤口愈合方面更具优势。
