title: Prospective randomized study of radical versus four piles haemorrhoidectomy for symptomatic large circumferential prolapsed piles.
abstract: Twenty-eight patients (14 men, 14 women) with circumferential prolapsed piles were prospectively randomized to undergo either modified radical haemorrhoidectomy (group 1; 14 patients) or four piles haemorrhoidectomy (group 2; 14). The median duration of surgery was 30 and 10 min respectively in groups 1 and 2. After operation all patients in group 1 were continent compared with 12 of 14 in group 2. Two patients in group 2 developed an anal stricture requiring manual dilatation. Five patients in group 1 had wound dehiscence requiring secondary suture; three of these developed an anal stricture: two needed anal dilatation and one required anoplasty. Two patients in group 1 had residual anal skin tags, compared with nine in group 2. Two patients in group 2 had symptomatic residual piles, whereas none in group 1 had this problem. At 6 months, six patients in group 2 considered the results to be excellent, seven acceptable and one was disappointed. In group 1 two considered the operation to be excellent, ten acceptable and two were disappointed.
authors.affiliation: Department of Colorectal Surgery, Singapore General Hospital.
authors.forename: F
authors.initials: F
authors.lastname: Seow-Choen
authors.forename: H C
authors.initials: HC
authors.lastname: Low
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011391:Prolapse; D011446:Prospective Studies; D016896:Treatment Outcome