We report the results of a prospective randomized study comparing 4 techniques of surgical treatment of haemorrhoids in the Day Surgery department of our teaching Hospital. The hypothesis of the study was that hemorrhoidectomy in day care is feasible and safe, the aim of the study was to compare 4 techniques: Ferguson closed Hemorrhoidectomy (FH), Milligan Morgan hemorrhoidectomy (MMH), Longo Hemorrhoidopexy (LH), Hemorrhoidectomy with Ligasure (radiofrequency) (RFH).
Patients and Methods: Between January 2004 and June 2007, 413 patients, 231 male and 182 female, mean age 48,28 +/- 12,97 were prospectively enrolled in this study and enclosed in a data base. Only ASA I and ASA II patients were included. Visual analogic scale (VAS) was recorded daily for 8 days. Postoperative duration of pain, soiling and bleeding, complications and recurrence were recorded. Statistical evaluation included chi square test for qualitative variables, parametric test for quantitative variables. Statistical testing was carried out on the basis of the following hypothesis: bilateral test and a first degree α-error risk of 0,05 (α=5%).
Results: pain in the first 8 days was less (p=0.05) in LH compared the other techniques which were not significantly different among them. Patients had prescription for Ketorolac 20 mg up to t.i.d. The rest of the data observed are gathered in table I. Postoperative pain duration showed LH vs MMH (p=0.05). Soiling and bleeding were significantly less in LH vs MMH,RDH,FH (p<0.02). Anal fissure was significantly higher in LH vs MMH and FH, p=0.05, while anal stricture was significantly higher in RFH vs LH p=0.05. recurrence and urgency at defecation had significantly higher rates in LH compared to MMH,FH,RFH.
Conclusion: LH had some advantages in postoperative symptoms pain, pain duration, soiling and bleeding compared to the other techniques, although showed higher rate of anal fissure, urgency and recurrence, and a higher cost.

	Longo	Ligasure	MMH	Ferguson
Number of cases	108	137	81	87
Pain durat. (days)	14±10,9	15,5±9,9	19,4±14,6	16,3±10,4
Soiling duration	5,6±8,5	17,8±17,4	17,5±13,2	19±18,9
Bleeding duration	6,5±8,5	11,3±13,8	18±15,2	15,2±13,6
Hitching duration	6,1±13,3	9,8±15,8	7,0±14,8	7,6±15,9
Complications
Anal fissure	6 (5.5%)	4 (2.9%)	0	1 (1.1%)
Anal stricture	2 (1.8%)	6 (4.3%)	2 (2,4%)	2 (2,3%)
Hemorrhage	5 (4,6%)	7 (5.1%)	2 (2.4%)	2 (2,3%)
Recurrence	6 (5,5%)	2 (1,4%)	2 (2,4%)	1 (1,1%)
Urgency	6 (5,5%)	2 (1,4%)	0	1 (1,1%)
Fecal incont.	1 (0,9%)	0	0	0