Ferguson Hemorrhoidectomy in the Surgical Treatment of Hemorrhoids

Öz

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.

Anahtar Kelimeler

• Hemorrhoids
• hemorrhoidectomy
• ferguson hemorrhoidectomy

Hemoroidlerin Cerrahi Tedavisinde Ferguson Hemoroidektomi

Öz

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.

Anahtar Kelimeler

• Hemoroid
• hemoroidektomi
• ferguson hemoroidektomi

Kaynakça

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