Ferguson hemorrhoidectomy with radiofrequency versus classic diathermy

BACKGROUND: This randomized study compared results obtained with the Ferguson's technique for the treatment of hemorrhoids performed with a radiofrequency (RF) scalpel and traditional diathermy. METHODS: 28 patients affected by grade IV hemorrhoids were randomized to receive either the Ferguson operation with the RF scalpel (group A) or traditional diathermy (group B). The operating time, intra- and postoperative bleeding, postoperative pain, and overall patient satisfaction were all recorded. RESULTS: Six patients (three for each group) did not attend follow-up controls. Group A showed a significant reduction of the surgical time (23 vs. 33 min; p < .01), pain at first postoperative day (Visual Analog Scale [VAS] score 3.4 vs. 4.8; p < .05), and at the first evacuation (3.4 vs. 5.0; p < .05). No significant differences were observed for the pain score at the seventh postoperative day, or overall satisfaction scores at the 7th postoperative day, and six months postoperatively (p = NS). No severe complications were recorded. Two patients in group A (18.2%) and four patients in group B (36.4%) reported transitory gas incontinence that spontaneously resolved within one month (p = NS). Three patients in group A (27.3%) and four patients in group B (36.4%) required postoperative catheterization due to urinary retention (p = NS). CONCLUSIONS: RF scalpel shortens the operating time of the Ferguson operation and is less painful in the early postoperative period.