Document Detail


Open vs. closed hemorrhoidectomy.
MedLine Citation:
PMID:  15690666     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: This prospective, randomized, clinical trial compared the outcome of surgical hemorrhoidectomy by open and closed techniques in terms of postoperative pain, wound healing, and morbidity. METHODS: All consecutive patients with Grade III internal hemorrhoids with prominent external components or Grade IV hemorrhoids were randomly allocated to one of two groups. The entire wound was left open in the open group and completely closed using 5-0 chromic sutures in the closed group. Postoperative pain was assessed by a linear analog scale. Additional consumption of oxycodone hydrochloride on the day of surgery and at defecation during the first week was recorded. Patients were followed up 1, 2, and 3 weeks after the procedure. RESULTS: There were 40 patients in each group. Pain score at recovery from the anesthesia was significantly lower in the closed group (P < 0.05). Altogether, 15 percent of patients in the closed group required additional oxycodone hydrochloride for pain compared to 45 percent in the open group (P < 0.01). The pain score at the first bowel movement was significantly lower in the closed group (P < 0.01). Wound healing was significantly faster in the closed group: 75 percent of patients in the closed group had healed at 3 weeks after the procedure compared to 18 percent in the open group (P < 0.001). CONCLUSIONS: The closed technique is more advantageous with respect to less pain during the early postoperative period and faster wound healing.
Authors:
Seong Y You; Seung H Kim; Choon S Chung; Dong K Lee
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  48     ISSN:  0012-3706     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-02-04     Completed Date:  2005-02-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  108-13     Citation Subset:  IM    
Affiliation:
Department of Colon and Rectal Surgery, Hang Clinic Gangnam, Seoul, Korea. seongyou@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anesthesia, General
Defecation
Female
Hemorrhoids / surgery*
Humans
Length of Stay
Male
Middle Aged
Pain, Postoperative
Prospective Studies
Suture Techniques*
Treatment Outcome
Wound Healing*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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