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Hemoroidlerin Cerrahi Tedavisinde Ferguson Hemoroidektomi

Year 2022, Issue 17, 403 - 410, 29.08.2022
https://doi.org/10.38079/igusabder.800766

Abstract

Amaç: Prolabe hemoroidal hastalık nedeniyle ameliyat edilen hastalarımızın ameliyatında geleneksel Ferguson yaklaşımının sonucunu değerlendirmek amaçlanmıştır.
Yöntem: Mart 2007-Ocak 2017 tarihleri arasında Ferguson tekniği ile tedavi edilen 769 hasta çalışmaya dahil edildi. Hastaların tıbbi dosyaları değerlendirilerek başvuru şikayetleri, anorektal komorbiditeler, ameliyat bulguları ve postoperatif erken ve geç komplikasyon verileri kaydedildi.
Bulgular: Hastaların% 65'i erkekti ve ortalama yaş 39 (18-81) idi. Şikayet süreleri bir hafta ile 5 yıl arasında değişiyordu. Şikayetler sık görülenden az görülene doğru sırasıyla ele gelen pake, kanama ve ağrı idi. Paker'l2r, hastaların %69'unda klasik konumdaydı (saat 3,5,7,11). Vakaların çoğu (% 65) 4. derece hemoroiddi. Hastaların%19'unda anorektal komorbidite olarak anal fissür vardı. Tüm hastalar litotomi pozisyonunda spinal anestezi altında ameliyat edildi. Ferguson tekniği için ameliyat süresi ortalama 20 dakika ve ameliyat sonrası hastanede kalış süresi ortalama bir gündü. Postoperatif dönemde 55 hastada erken komplikasyonlar gelişti. Bunlar 25 hastada (%3-25) şiddetli karın ağrısı, 3 hastada (% 0.4) kanama ve 28 hastada (% 3.60) idrar retansiyonu idi. Yedi hastada geç komplikasyonlar gelişti. 1 hastada anal stenoz, 3 hastada anal fissür ve 2 hastada apse ile fistül gelişti. Hiçbir hastada inkontinans ve nüks görülmedi.
Sonuç: Ferguson tekniği halen hemoroid cerrahisinde kullanılmaktadır. Çalışmamızın sonuçları, güvenilir bir tercih yöntemi olarak Ferguson hemoroidektomisini desteklemektedir.

References

  • Ozer MT, Yigit T, Uzar AL, et al. A comparison of different hemorrhoidectomy procedures. Sauidi Med J. 2008;29(9):1264-9.
  • Milone M, Maietta P, Leongito M, Pesce G, Salvatore G, Milone F. Ferguson hemorrhoidectomy: Is still the gold standard treatment? Updates Surg. 2012;64(3):191-4.
  • MacRae HM, McLeod RS. Stapled versus Ferguson hemorrhoidectomy: Is there any evidence-based information. Int J Colorectal Dis. 2008;23(9):825-32.
  • Fareed M, El-Awady S, Abd-El monaem H, Aly A. Randomized trial comparing LigaSure to closed Ferguson hemorrhoidectomy. Tech Coloproctol. 2009;13(3):243-6.
  • Altomare DF, Milito G, Andreoli R, et al. Ligasure Precise vs. conventional diathermy for Milligan-Morgan hemorrhoidectomy: A prospective, randomized, multicenter trial. Dis Colon Rectum. 2008;51:514–519.
  • Khafagy W, El Nakeeb A, Fouda E, et al. Conventional haemorrhoidectomy, stapled haemorrhoidectomy, Doppler guided haemorrhoidectomy artery ligation; post operative pain and anorectal manometric assessment. Hepatogastroenterology. 2009;56:1010–1015.
  • Jayaraman S, Colquhoun PH, Malthaner RA. Stapled versus conventional surgery for hemorrhoids. Cochrane Database Syst Rev. 2006;18:CD005393.
  • Ivanov D, Babović S, Selesi D, Cvjanovic R. Harmonic Scalpel hemorrhoidectomy: A painless procedure? Med Pregl. 2007;60:421–426.
  • Amoli HA, Notash AY, Shahandashti FJ, Kenari AY, Ashraf H. A randomized, prospective, double-blind, placebo controlled trial of the effect of topical diltiazem on post-hemorrhoidectomy pain. Colorectal Dis. 2009;70:641-650.
  • Shiau JM, Hung KC, Chen HH, et al. Combination of topical EMLA with local injection of lidocaine: superior pain relief after Ferguson hemorrhoidectomy. Clin J Pain. 2007;23(7):586-90.
  • Carditello A, Stilo F. Ferguson hemorrhoidectomy, modified by using the Ligasure radiofrequency coagulator. Chir Ital. 2007;59(1):99-104.
  • Ho KS, Ho YH. Prospective randomized trial comparing stapled hemorrhoidopexy versus closed Ferguson hemorrhoidectomy. Tech Coloproctol. 2006;10(3):193-7.
  • Shao WJ, Li GC, Zhang ZH, Yang BL, Sun GD, Chen YQ. Systematic review and meta- analysis of randomized controlled trials comparing stapled haemorrhoidopexy with conventional haemorrhoidectomy. Br J Surg. 2008;95:147–160.
  • Bulus H, Tas A, Coskun A. Evaluation of two hemorrhoidectomy techniques: Harmonic scalpel and Ferguson's with electrocautery. Asian J Surg. 2014;37(1):20-3.
  • Madoff RD, Fleshman JW. Clinical Practice Committee, American Gastroenterological Association. American Gastroenterological Association technical review on the diagnosis and treatment of hemorrhoids. Gastroenterology. 2004;126:1463–1473.
  • Pandini LC, Nahas SC, Nahas CS, Marques CF, Sobrado CW, Kiss DR. Surgical treatment of haemorrhoidal disease with CO2 laser and Milligan-Morgan cold scalpel technique. Colorectal Dis. 2006;8:592-595.
  • Kanellos I, Zacharakis E, Christoforidis E, et al. Usefulness of lateral internal sphincterotomy in reducing postoperative pain after open hemorrhoidectomy. World J Surg. 2005;29:464–468.
  • Charúa-Guindic L, Avendaño-Espinosa O, Jiménez-Bobadilla B, Pivaral-Martínez R. Results and analysis of Ferguson-type hemorrhoidectomy. Cir Cir. 2007;75(3):181-9.
  • Aytac E, Gorgun E, Erem HH, Abbas MA, Hull TL, Remzi FH. Long-term outcomes after circular stapled hemorrhoidopexy versus Ferguson hemorrhoidectomy. Tech Coloproctol. 2015;19(10):653-8.
  • Bhatti MI, Sajid MS, Baig MK. Milligan-Morgan (Open) versus Ferguson hemorrhoidectomy (closed): A systematic review and meta-analysis of published randomized, controlled trials. World J Surg. 2016;40(6):1509-19.

Ferguson Hemorrhoidectomy in the Surgical Treatment of Hemorrhoids

Year 2022, Issue 17, 403 - 410, 29.08.2022
https://doi.org/10.38079/igusabder.800766

Abstract

Aim: To assess the outcome of the conventional Ferguson approach in the surgery of our patients who were operated on for prolapsed internal hemorrhoid.
Method: 769 patients who were treated with the Ferguson technique between March 2007 and January 2017 were included in the study. Patients' medical files were assessed and, the complaints at presentation, anorectal comorbidities, operation findings and postoperative early and late complication data were recorded.
Results: 65% of the patients were male and the mean age was 39 years (18 -81). The durations of complaints varied between one week and 5 years. In the order of higher to lower frequency the complaints were palpable pakers, bleeding and pain respectively. The pakers were at classical locations (3,5,7,11 o’clock) in 69 % of patients. Most of the cases (65%) were grade 4 hemorroid. 19 % of patients had anal fissures as anorectal comorbidity. All patients were operated on at the lithotomy position under spinal anaesthesia. Operation time for ferguson technique was on average 20 minutes and postoperative stay in hospital was one day on average. During the postoperative period, 55 patients developed early complications. These included severe abdominal pain in 25 patients (3-25%), bleeding in 3 (0,4%) and urine retention in 28 (3.60%). Late complications developed in 7 patients. There developed anal stenosis in one patient, anal fissure in 3 and fistula with an abscess in 2. Incontinence and recurrence were not observed in any patient.
Conclusion: Ferguson technique is still employed for hemorrhoid surgery. The results of our study support the Ferguson hemorrhoidectomy as a reliable method of preference.

References

  • Ozer MT, Yigit T, Uzar AL, et al. A comparison of different hemorrhoidectomy procedures. Sauidi Med J. 2008;29(9):1264-9.
  • Milone M, Maietta P, Leongito M, Pesce G, Salvatore G, Milone F. Ferguson hemorrhoidectomy: Is still the gold standard treatment? Updates Surg. 2012;64(3):191-4.
  • MacRae HM, McLeod RS. Stapled versus Ferguson hemorrhoidectomy: Is there any evidence-based information. Int J Colorectal Dis. 2008;23(9):825-32.
  • Fareed M, El-Awady S, Abd-El monaem H, Aly A. Randomized trial comparing LigaSure to closed Ferguson hemorrhoidectomy. Tech Coloproctol. 2009;13(3):243-6.
  • Altomare DF, Milito G, Andreoli R, et al. Ligasure Precise vs. conventional diathermy for Milligan-Morgan hemorrhoidectomy: A prospective, randomized, multicenter trial. Dis Colon Rectum. 2008;51:514–519.
  • Khafagy W, El Nakeeb A, Fouda E, et al. Conventional haemorrhoidectomy, stapled haemorrhoidectomy, Doppler guided haemorrhoidectomy artery ligation; post operative pain and anorectal manometric assessment. Hepatogastroenterology. 2009;56:1010–1015.
  • Jayaraman S, Colquhoun PH, Malthaner RA. Stapled versus conventional surgery for hemorrhoids. Cochrane Database Syst Rev. 2006;18:CD005393.
  • Ivanov D, Babović S, Selesi D, Cvjanovic R. Harmonic Scalpel hemorrhoidectomy: A painless procedure? Med Pregl. 2007;60:421–426.
  • Amoli HA, Notash AY, Shahandashti FJ, Kenari AY, Ashraf H. A randomized, prospective, double-blind, placebo controlled trial of the effect of topical diltiazem on post-hemorrhoidectomy pain. Colorectal Dis. 2009;70:641-650.
  • Shiau JM, Hung KC, Chen HH, et al. Combination of topical EMLA with local injection of lidocaine: superior pain relief after Ferguson hemorrhoidectomy. Clin J Pain. 2007;23(7):586-90.
  • Carditello A, Stilo F. Ferguson hemorrhoidectomy, modified by using the Ligasure radiofrequency coagulator. Chir Ital. 2007;59(1):99-104.
  • Ho KS, Ho YH. Prospective randomized trial comparing stapled hemorrhoidopexy versus closed Ferguson hemorrhoidectomy. Tech Coloproctol. 2006;10(3):193-7.
  • Shao WJ, Li GC, Zhang ZH, Yang BL, Sun GD, Chen YQ. Systematic review and meta- analysis of randomized controlled trials comparing stapled haemorrhoidopexy with conventional haemorrhoidectomy. Br J Surg. 2008;95:147–160.
  • Bulus H, Tas A, Coskun A. Evaluation of two hemorrhoidectomy techniques: Harmonic scalpel and Ferguson's with electrocautery. Asian J Surg. 2014;37(1):20-3.
  • Madoff RD, Fleshman JW. Clinical Practice Committee, American Gastroenterological Association. American Gastroenterological Association technical review on the diagnosis and treatment of hemorrhoids. Gastroenterology. 2004;126:1463–1473.
  • Pandini LC, Nahas SC, Nahas CS, Marques CF, Sobrado CW, Kiss DR. Surgical treatment of haemorrhoidal disease with CO2 laser and Milligan-Morgan cold scalpel technique. Colorectal Dis. 2006;8:592-595.
  • Kanellos I, Zacharakis E, Christoforidis E, et al. Usefulness of lateral internal sphincterotomy in reducing postoperative pain after open hemorrhoidectomy. World J Surg. 2005;29:464–468.
  • Charúa-Guindic L, Avendaño-Espinosa O, Jiménez-Bobadilla B, Pivaral-Martínez R. Results and analysis of Ferguson-type hemorrhoidectomy. Cir Cir. 2007;75(3):181-9.
  • Aytac E, Gorgun E, Erem HH, Abbas MA, Hull TL, Remzi FH. Long-term outcomes after circular stapled hemorrhoidopexy versus Ferguson hemorrhoidectomy. Tech Coloproctol. 2015;19(10):653-8.
  • Bhatti MI, Sajid MS, Baig MK. Milligan-Morgan (Open) versus Ferguson hemorrhoidectomy (closed): A systematic review and meta-analysis of published randomized, controlled trials. World J Surg. 2016;40(6):1509-19.

Details

Primary Language English
Subjects Medicine
Journal Section Articles
Authors

Fatih ÇİFTCİ> (Primary Author)
ISTANBUL GELISIM UNIVERSITY
0000-0001-9125-8696
Türkiye


Turgut ANUK>
KAFKAS UNIVERSITY, SCHOOL OF MEDICINE
0000-0002-8903-9993
Türkiye

Publication Date August 29, 2022
Published in Issue Year 2022, Volume , Issue 17

Cite

Bibtex @research article { igusabder800766, journal = {İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi}, issn = {2536-4499}, eissn = {2602-2605}, address = {İstanbul Gelişim Üniversitesi Sağlık Bilimleri Yüksekokulu - Cihangir Mah. Şehit Jandarma Komando Er Hakan Öner Sk. No: 1 Avcılar / İstanbul / Türkiye}, publisher = {İstanbul Gelisim University}, year = {2022}, number = {17}, pages = {403 - 410}, doi = {10.38079/igusabder.800766}, title = {Ferguson Hemorrhoidectomy in the Surgical Treatment of Hemorrhoids}, key = {cite}, author = {Çiftci, Fatih and Anuk, Turgut} }
APA Çiftci, F. & Anuk, T. (2022). Ferguson Hemorrhoidectomy in the Surgical Treatment of Hemorrhoids . İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi , (17) , 403-410 . DOI: 10.38079/igusabder.800766
MLA Çiftci, F. , Anuk, T. "Ferguson Hemorrhoidectomy in the Surgical Treatment of Hemorrhoids" . İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi (2022 ): 403-410 <https://dergipark.org.tr/en/pub/igusabder/issue/72351/800766>
Chicago Çiftci, F. , Anuk, T. "Ferguson Hemorrhoidectomy in the Surgical Treatment of Hemorrhoids". İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi (2022 ): 403-410
RIS TY - JOUR T1 - Ferguson Hemorrhoidectomy in the Surgical Treatment of Hemorrhoids AU - FatihÇiftci, TurgutAnuk Y1 - 2022 PY - 2022 N1 - doi: 10.38079/igusabder.800766 DO - 10.38079/igusabder.800766 T2 - İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi JF - Journal JO - JOR SP - 403 EP - 410 VL - IS - 17 SN - 2536-4499-2602-2605 M3 - doi: 10.38079/igusabder.800766 UR - https://doi.org/10.38079/igusabder.800766 Y2 - 2022 ER -
EndNote %0 Istanbul Gelisim University Journal of Health Sciences Ferguson Hemorrhoidectomy in the Surgical Treatment of Hemorrhoids %A Fatih Çiftci , Turgut Anuk %T Ferguson Hemorrhoidectomy in the Surgical Treatment of Hemorrhoids %D 2022 %J İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi %P 2536-4499-2602-2605 %V %N 17 %R doi: 10.38079/igusabder.800766 %U 10.38079/igusabder.800766
ISNAD Çiftci, Fatih , Anuk, Turgut . "Ferguson Hemorrhoidectomy in the Surgical Treatment of Hemorrhoids". İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi / 17 (August 2022): 403-410 . https://doi.org/10.38079/igusabder.800766
AMA Çiftci F. , Anuk T. Ferguson Hemorrhoidectomy in the Surgical Treatment of Hemorrhoids. IGUSABDER. 2022; (17): 403-410.
Vancouver Çiftci F. , Anuk T. Ferguson Hemorrhoidectomy in the Surgical Treatment of Hemorrhoids. İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi. 2022; (17): 403-410.
IEEE F. Çiftci and T. Anuk , "Ferguson Hemorrhoidectomy in the Surgical Treatment of Hemorrhoids", İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi, no. 17, pp. 403-410, Aug. 2022, doi:10.38079/igusabder.800766

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