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Background: Studies of haemorrhoidectomy usually report postoperative pain, healing and complications, but rarely consider anal function in the longer term. The primary aim of this randomized trial was to compare long-term changes in anal function after open (Milligan-Morgan) and closed (Ferguson) haemorrhoidectomy. Methods: A total of 225 patients were included in the trial, 115 in the open group and 110 in the closed group. Continence changes were recorded by means of validated questions and an incontinence score. Pain was self-reported using a visual analogue scale. Results: Postoperative pain and complications did not differ between the groups. Time to recovery was 17 days in the Milligan-Morgan group and 15 days in the Ferguson group. After 1 month the wounds were healed in 57.0 per cent of patients in the open group and 70.6 per cent of those in the closed group (P = 0.058). At 1 year, 78.9 per cent of the Milligan-Morgan group and 85.3 per cent of the Ferguson group reported no continence disturbance (P = 0.072). The incontinence score was improved at 1 year in the closed group (P = 0.015), but was unchanged in the open group (P = 0.645). Patients who had the Ferguson procedure were more satisfied with the outcome of surgery (P = 0.047). Conclusion: Closed Ferguson haemorrhoidectomy was superior to the open Milligan-Morgan procedure with respect to long-term anal continence and patient satisfaction. [ABSTRACT FROM AUTHOR]

Examines whether intussusception morphology differs between patients with evacuatory dysfunction and healthy volunteers. Measurement of various morphological parameters in patients with disordered rectal evacuation, in whom an isolated intussusception was seen on proctography; Designation of intussusception thickness greater than 3 millimeters as full thickness; Greater incidence of intussusception thickness in the symptomatic group; Indication that rectal intussusception in patients with evacuatory dysfunction is more advanced morphologically than that seen in asymptomatic controls.

Evaluates the functional and physiological outcome following transanal repair of rectocele. Development of a wound infection after surgery; Reduction in incomplete evacuation through isotope defaecography; Occurrence of symptomatic feeling of prolapse.

Analyzes the surgical management of anorectal melanoma. Determinants of prognosis for any primary melanoma; Effect of chemotherapy on patients with melanoma; Role of combined-modality therapy on the curative treatment of anorectal melanoma.