SURGICAL-TREATMENT OF PILES - PROSPECTIVE, RANDOMIZED STUDY OF PACKS VS. MILLIGAN-MORGAN HEMORRHOIDECTOMY

PURPOSE: The present prospective, randomized clinical trial compares t he outcome of surgical hemorrhoidectomy according to Parks and Milliga n-Morgan in terms of hospital stay, duration of incapacity to work, sy mptom relief, length of morbidity, and patient convenience. METHODS: T hirty-four consecutive patients with third Or fourth degree internal h emorrhoids were randomly allocated to the two groups. Before surgery, all patients were interviewed using a standard questionnaire, followed by rectal examination. Ail patients underwent a follow-up interview a nd examinations 1, 2, 4, 8, and 12 weeks after the operation. RESULTS: No serious postoperative complications were seen. Length of hospital stay (3.2 days for Parks hemorrhoidectomy vs. 4.6 days for Milligan-Mo rgan hemorrhoidectomy; 95 percent confidence interval, 0.2 and 2.6, re spectively; P = 0.02) and mean duration of incapacity to work (12.3 da ys for Parks hemorrhoidectomy vs. 20.2 days for Milligan-Morgan hemorr hoidectomy; 95 percent confidence interval, 5.7 and 10.2, respectively ; P < 0.001) differed significantly between the Milligan-Morgan and Pa rks patients. Until two weeks after the operation, Milligan-Morgan hem orrhoidectomy patients experienced significantly more pain. CONCLUSION S: Our study confirms that both operations are safe, easy to perform, and lead to satisfactory results. However, the Parks procedure is the preferred option, because it minimizes patients' postoperative discomf ort, is more economic, has a significantly reduced hospital stay, and has a shorter time for return to work.