title: Ferguson hemorrhoidectomy: long-term results and patient satisfaction after Ferguson's hemorrhoidectomy.
abstract: OBJECTIVE
  Perioperative morbidity and long-term results after hemorrhoidectomy (Ferguson's technique) were evaluated as a basis for comparison with new methods such as stapled hemorrhoidectomy.
  
  
  METHODS
  All records of patients who underwent conventional hemorrhoidectomy between January 1, 1993 and December 31, 1997 (five years) were retrospectively analyzed. The surgical technique was Ferguson closed hemorrhoidectomy. Long-term results were evaluated with a standardized questionnaire that was sent to all patients.
  
  
  RESULTS
  Five-hundred-fourteen patients (195 female, 319 male) with a mean age of 52 (range, 22-96) years were evaluated. Postoperatively, seven patients had a relevant hemorrhage, and two had to undergo reoperation (reoperation rate within 30 days, 0.4 percent). In 15 cases (3 percent) patients received urinary catheters for postoperative urinary retention. Mortality was 0 percent. The questionnaire was returned by 403 patients (78.4 percent). The mean follow-up was 4.7 (range, 2.1-7.8) years. The leading symptom was relieved in 275 patients (67.4 percent), ameliorated in 111 (27.2 percent), and unchanged or worse in 22 (5.4 percent). Incontinence (soiling) was not present in 291 (71.7 percent) patients, light in 86 (21.2 percent), moderate in 25 (6.1 percent), and severe in 4 (0.98 percent). Reoperation rate for recurrent hemorrhoids was 0.8 percent. Patients evaluated the surgical result as excellent in 286 (70.5 percent) cases, good in 87 (21.4 percent), moderate in 25 (6.2 percent), and bad in 8 (1.9 percent) cases.
  
  
  CONCLUSIONS
  Ferguson closed hemorrhoidectomy results in very low rates of perioperative morbidity. Long-term results demonstrate high patient satisfaction and low incontinence and reoperation rates. It could be the gold standard to which other techniques are compared.
authors.affiliation: Department of Surgery, St. Claraspital, Basel, Switzerland. marc.guenin@claraspital.ch
authors.forename: Marc-Olivier
authors.initials: MO
authors.lastname: Guenin
authors.forename: Rachel
authors.initials: R
authors.lastname: Rosenthal
authors.forename: Beatrice
authors.initials: B
authors.lastname: Kern
authors.forename: Ralph
authors.initials: R
authors.lastname: Peterli
authors.forename: Markus
authors.initials: M
authors.lastname: von Flüe
authors.forename: Christoph
authors.initials: C
authors.lastname: Ackermann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001004:Anus Diseases / Q000209:etiology; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications; D019106:Postoperative Hemorrhage / Q000209:etiology; D012086:Reoperation; D012189:Retrospective Studies; D017792:Surgical Stapling; D016896:Treatment Outcome; D016055:Urinary Retention / Q000209:etiology