Abstract
Purpose
We describe a modification of the Ferguson hemorrhoidectomy for circumferential prolapsed hemorrhoids. This details the operative procedure and compares the results of other radical methods in patients with circumferential hemorrhoidal disease.
Methods
A total of 738 patients (mean age, 43 (range, 19–83) years) were treated with our modified Ferguson method under sedative analgesia between 1989 and 2004: 576 patients had Grade III and 162 patients had Grade IV hemorrhoids, and 131 patients also had a partial lateral internal sphincterotomy to correct anal hypertonia.
Results
Postoperative bleeding occurred in 16 patients, 3 of whom required surgical hemostasis. Fecal impaction occurred in 11 patients and wound complications in 6 patients. Thirty-two patients needed bladder catheterization because of acute urinary retention. The median follow-up was 13.2 months in our outpatient department. One patient developed mild gas incontinence, five developed anal stenosis, and three had an anal fissure. Only three patients had recurrent skin tags, which did not affect their quality of life.
Conclusions
Our modified Ferguson method represents a good choice for radical treatment of circumferential prolapsed hemorrhoids because it is easy to perform, has few complications, and provides satisfying results.
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References
Gençosmanolu R, Sad O, Koç D, Inceoglu R. Hemorrhoidectomy: open or closed technique? A prospective, randomized, clinical trial. Dis Colon Rectum 2002;45:70–5.
Whitehead W. The surgical treatment of haemorrhoids. BMJ 1882;1:148.
Wolff BG, Culp CE. The Whitehead hemorrhoidectomy. An unjustly maligned procedure. Dis Colon Rectum 1988;31:587–90.
Rand AA. The sliding skin-flap graft operation for hemorrhoids: a modification of the Whitehead procedure. Dis Colon Rectum 1969;12:265–76.
White JE, Syphax B, Funderburk WW. A modification of the Whitehead hemorrhoidectomy. Surg Gynec Obstet 1972;134:103–5.
Burchell MC, Thow GB, Mannson RR. A “modified Whitehead” hemorrhoidectomy. Dis Colon Rectum 1976;19:225–32.
Maria G, Brisinda G, Civello IM. Anoplasty for the treatment of anal stenosis. Am J Surg 1998;175:158–60.
Wang C-H. Urgent hemorrhoidectomy for hemorrhoidal crisis. Dis Colon Rectum 1982;25:122–4.
Bonello JC. Who’s afraid of the dentate line? The Whitehead hemorrhoidectomy. Am J Surg 1988;156:182–6.
Corman ML. Colon and rectal surgery. 5th ed. Philadelphia: Lippincott, 2005:218–9.
Boccasanta P, Venturi M, Orio A, et al. Circular hemorrhoidectomy in advanced hemorrhoidal disease. Hepato-gastroenterol 1998;45:969–72.
Buie LA. Proctoscopic examination and the treatment of hemorrhoids and anal pruritis. Philadelphia: WB Saunders, 1932.
Fansler WA, Anderson JK. A plastic operation for certain types of hemorrhoids. JAMA 1933;101:1064–6.
Barrios G, Khubchandani M. Whitehead operation revisited. Dis Colon Rectum 1979:22:330–2.
Denis J, Dubios N, Ganansia R, du Puy-Montbrun T, Lemarchand N. Hemorrhoidectomy: Hospital Leopold Bellan procedure. Int Surg 1989;74:152–3.
Maria G, Alfonsi G, Nigro C, Brisinda G. Whitehead’s hemorrhoidectomy. A useful surgical procedure in selected cases. Tech Coloproctol 2001;5:93–6.
Seow-Choen F, Low HC. Prospective randomized study of radical versus four piles haemorrhoidectomy for symptomatic large circumferential prolapsed piles. Br J Surg 1995;82:188–9.
Hodedadi J, Kurgan A, Jersky J. The Whitehead operation for advanced hemorrhoids. Dis Colon Rectum 1979;22:238–40.
Khubchandani M. Results of Whitehead operation. Dis Colon Rectum 1984;27:730–2.
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Wang, LT., Wu, CC., Hsiao, CW. et al. A Modified Ferguson Hemorrhoidectomy for Circumferential Prolapsed Hemorrhoids with Skin Tags. Dis Colon Rectum 51, 456–461 (2008). https://doi.org/10.1007/s10350-007-9179-y
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DOI: https://doi.org/10.1007/s10350-007-9179-y