title: Long-term outcomes after circular stapled hemorrhoidopexy versus Ferguson hemorrhoidectomy.
abstract: BACKGROUND
  We aimed to compare long-term outcomes and quality of life in patients undergoing circular stapled hemorrhoidopexy to those who had Ferguson hemorrhoidectomy.
  
  
  METHODS
  Patients who underwent Ferguson hemorrhoidectomy and circular stapled hemorrhoidopexy between 2000 and 2010 were reviewed. Long-term follow-up was assessed with questionnaires.
  
  
  RESULTS
  Two hundred seventeen patients completed the questionnaires. Mean follow-up was longer in the Ferguson hemorrhoidectomy subgroups (7.7 ± 3.4 vs. 6.3 ± 2.9 years, p = 0.003). Long-term need for additional surgical or medical treatment was similar in the Ferguson hemorrhoidectomy and circular stapled hemorrhoidopexy groups (3 vs. 5%, p = 0.47 and 3% in both groups, p > 0.99, respectively). Eighty-one percentage of Ferguson hemorrhoidectomy and 83% of circular stapled hemorrhoidopexy patients stated that they would undergo hemorrhoid surgery again if needed (p = 0.86). The symptoms were greatly improved in the majority of patients (p = 0.06), and there was no difference between the groups as regards long-term anorectal pain (p = 0.16). The Cleveland global quality of life, fecal incontinence severity index, and fecal incontinence quality of life scores were similar (p > 0.05).
  
  
  CONCLUSIONS
  This is one of the longest follow-up studies comparing the outcomes after circular stapled hemorrhoidopexy and Ferguson hemorrhoidectomy. Patient satisfaction, resolution of symptoms, quality of life, and functional outcome appear similar after circular stapled hemorrhoidopexy and Ferguson hemorrhoidectomy in long term.
authors.affiliation: Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave. A30, Cleveland, OH, 44195, USA.
authors.forename: E
authors.initials: E
authors.lastname: Aytac
authors.affiliation: Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave. A30, Cleveland, OH, 44195, USA. gorgune@ccf.org.
authors.forename: E
authors.initials: E
authors.lastname: Gorgun
authors.affiliation: Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave. A30, Cleveland, OH, 44195, USA.
authors.forename: H H
authors.initials: HH
authors.lastname: Erem
authors.affiliation: Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave. A30, Cleveland, OH, 44195, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Abbas
authors.affiliation: Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave. A30, Cleveland, OH, 44195, USA.
authors.forename: T L
authors.initials: TL
authors.lastname: Hull
authors.affiliation: Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave. A30, Cleveland, OH, 44195, USA.
authors.forename: F H
authors.initials: FH
authors.lastname: Remzi
mesh_terms: D000368:Aged; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005242:Fecal Incontinence / Q000209:etiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D061865:Hemorrhoidectomy / Q000379:methods* / Q000523:psychology / Q000706:statistics & numerical data; D006484:Hemorrhoids / Q000150:complications / Q000523:psychology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology; D017060:Patient Satisfaction; D011788:Quality of Life; D012720:Severity of Illness Index; D017792:Surgical Stapling / Q000379:methods* / Q000523:psychology / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*
keywords: Circular stapled hemorrhoidopexy; Ferguson hemorrhoidectomy; Functional outcome; Long-term; Quality of life