RANDOMIZED CONTROLLED TRIAL OF OPEN AND CLOSED HEMORRHOIDECTOMY

Background This study was a prospective randomized comparison of heali ng following open and closed haemorrhoidectomy. Methods Sixty-seven co nsecutive patients (mean(s.e.m.) age 45(1.7) years; 35 men, 32 women) with three prolapsed piles were randomized to open haemorrhoidectomy ( n = 34) or closed haemorrhoidectomy (n = 33). Results Mean(s.e.m.) fol low-up was 8.7(0.2) months. There were no differences in the linear an alogue pain scores, analgesic requirements and length of hospitalizati on after open haemorrhoidectomy and closed haemorrhoidectomy. Complete wound healing took significantly longer after closed haemorrhoidectom y (mean(s.e.m.) 6.9(0.7) weeks) compared with open haemorrhoidectomy ( 4.9(0.4) weeks) (P < 0.05). This was related to wound dehiscence in ei ght patients. Complication rates, however, were similar except for pro longed serous discharge from unhealed wounds. The anal manometry findi ngs after both procedures were equivalent. Conclusion Open haemorrhoid ectomy leads to faster and more reliable wound healing, although this did not result in less pain or fewer complications.