An evaluation of Milligan-Morgan and Ferguson procedures for haemorrhoidectomy at Liaquat University Hospital Jamshoro, Hyderabad, Pakistan

Objective: to 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.methodology: in this prospective, randomized clinical study conducted between january 2005 to december 2008, 213 patients with late 2nd 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.results: 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.conclusions: the closed technique is more beneficial with respect to postoperative pain, control of bleeding, early mobilization of patients and wound healing