PROSPECTIVE RANDOMIZED STUDY OF RADICAL VERSUS 4 PILES HEMORRHOIDECTOMY FOR SYMPTOMATIC LARGE CIRCUMFERENTIAL PROLAPSED PILES

Twenty-eight patients (14 men, 14 women) with circumferential prolapse d piles were prospectively randomized to undergo either modified radic al haemorrhoidectomy (group 1; 14 patients) or four piles haemorrhoide ctomy (group 2; 14). The median duration of surgery was 30 and 10 min respectively in groups 1 and 2. After operation all patients in group 1 were continent compared with 12 of 14 in group 2. Two patients in gr oup 2 developed an anal stricture requiring manual dilatation. Five pa tients in group 1 had wound dehiscence requiring secondary suture; thr ee of these developed an anal stricture: two needed anal dilatation an d one required anoplasty. Two patients in group 1 had residual anal sk in tags, compared with nine in group 2. Two patients in group 2 had sy mptomatic residual piles, whereas none in group 1 had this problem. At 6 months, six patients in group 2 considered the results to be excell ent, seven acceptable and one was disappointed. In group 1 two conside red the operation to be excellent, ten acceptable and two were disappo inted.