{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T11:23:43Z","timestamp":1768217023745,"version":"3.49.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to evaluate the efficacy and safety of modified Ferguson hemorrhoidectomy (MFH) compared with conventional Milligan-Morgan hemorrhoidectomy (MMH) for grade II\u2013IV hemorrhoids.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort of patients undergoing MFH or MMH between September 2020 and August 2021 was reviewed. The primary outcomes were healing time and recurrence after at least 24\u202fmonths of follow-up. Secondary outcomes included Hemorrhoidal Disease Symptom Score (HDSS), postoperative complications, patient satisfaction, and quality-of-life assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 515 patients were enrolled (MFH,\n                      <jats:italic>n<\/jats:italic>\n                      =\u202f254; MMH,\n                      <jats:italic>n<\/jats:italic>\n                      =\u202f261) with a median follow-up of 29\u202fmonths. The recurrence rate was significantly lower in the MFH group compared with MMH (1.2% vs. 5.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.013), with Kaplan\u2013Meier analysis confirming superior recurrence-free survival (98.8% vs. 95.0% at 36\u202fmonths). Healing time was shorter with MFH (26.3\u202f\u00b1\u202f4.3 vs. 30.9\u202f\u00b1\u202f3.5\u202fdays,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). MFH reduced the risk of postoperative edema (2.4% vs. 9.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.01; OR 0.23, 95% CI 0.09\u20130.56) but showed a higher incidence of urinary retention (3.9% vs. 1.1%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.04). No anal stenosis or fecal incontinence was observed in either group. Patient satisfaction was higher in MFH (9.7\u202f\u00b1\u202f0.7 vs. 9.4\u202f\u00b1\u202f1.2,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.002), and improvements in HDSS and SHSHD scores were sustained during long-term follow-up. Multivariate regression confirmed MFH as an independent protective factor against recurrence (adjusted OR 0.26, 95% CI 0.08\u20130.91,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.035).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Modified Ferguson hemorrhoidectomy is a safe and effective technique for grade II-IV hemorrhoids, offering lower recurrence, shorter healing, fewer complications, and higher satisfaction compared with Milligan-Morgan hemorrhoidectomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1710244","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T08:12:29Z","timestamp":1768205549000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Modified Ferguson hemorrhoidectomy for grade II\u2013IV hemorrhoids offers low recurrence and complication rates: a retrospective cohort 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