Surgical treatment of piles: prospective, randomized study of Parks vs. Milligan-Morgan hemorrhoidectomy.
OBJECTIVE
The present prospective, randomized clinical trial compares the outcome of surgical hemorrhoidectomy according to Parks and Milligan-Morgan in terms of hospital stay, duration of incapacity to work, symptom relief, length of morbidity, and patient convenience.


METHODS
Thirty-four consecutive patients with third or fourth degree internal hemorrhoids were randomly allocated to the two groups. Before surgery, all patients were interviewed using a standard questionnaire, followed by rectal examination. All patients underwent a follow-up interview and examinations 1, 2, 4, 8, and 12 weeks after the operation.


RESULTS
No serious postoperative complications were seen. Length of hospital stay (3.2 days for Parks hemorrhoidectomy vs. 4.6 days for Milligan-Morgan hemorrhoidectomy; 95 percent confidence interval, 0.2 and 2.6, respectively; P = 0.02) and mean duration of incapacity to work (12.3 days for Parks hemorrhoidectomy vs. 20.2 days for Milligan-Morgan hemorrhoidectomy; 95 percent confidence interval, 5.7 and 10.2, respectively; P < 0.001) differed significantly between the Milligan-Morgan and Parks patients. Until two weeks after the operation, Milligan-Morgan hemorrhoidectomy patients experienced significantly more pain.


CONCLUSIONS
Our study confirms that both operations are safe, easy to perform, and lead to satisfactory results. However, the Parks procedure is the preferred option, because it minimizes patients' postoperative discomfort, is more economic, has a significantly reduced hospital stay, and has a shorter time for return to work.
Hosch
S B
SB
Department of Surgery, University of Hamburg, Germany.
Knoefel
W T
WT
Pichlmeier
U
U
Schulze
V
V
Busch
C
C
Gawad
K A
KA
Broelsch
C E
CE
Izbicki
J R
JR
D005260:Female; D006484:Hemorrhoids / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D007407:Interviews as Topic; D007902:Length of Stay; D008297:Male; D008722:Methods; D008875:Middle Aged; D011182:Postoperative Care; D011446:Prospective Studies; D011795:Surveys and Questionnaires