Scores values tended to decrease postoperatively .
The comparison between haemorrhoidal treatments is still unclear .
Attempts have been made to adopt a unifying postoperative scoring system and thus ensure adequate comparison between clinical trials .
We aim ed to systematic ally review the available outcome scores of haemorrhoidal treatment .
Minimal open hemorrhoidectomy
The original operation for  open hemorrhoidectomy  as described by Milligan – Morgan is no longer used . There is a great variation in how the operation is described in clinical trials . A number of modifications have been proposed attempting to reduce postoperative pain . An anatomical plane for the dissection was first described by Loder and Phillips [ 1 ] . They encountered small fibers passing from the internal sphincter to the anal cushions and emphasized the importance of dividing these fibers close to the cushions leaving an intact surface over the internal sphincter . Gerjy et al. described a subdermal fascia continuing into a membrane covering the internal sphincter , which was easily identified after incision of the skin of the pedicle [ 2 ] . In addition , Loder and Phillips were the first to suggest diathermy dissection and coagulation [ 1 ] . A better knowledge of hemorrhoidal vascular anatomy , demonstrating , how the arterial supply to the hemorrhoids crosses the rectal wall , has reduced the need for pedicle ligation . Seow-Chonen et al. demonstrated in a r and omized study that diathermy dissection , when compared to scissor dissection , result ed in less postoperative pain and Bessa et al. showed how diathermy coagulation of the pedicle was superior to ligation in reducing postoperative pain [ 3 , 4 ] . We adapted these principles and also minimized excision of the skin and the hemorrhoid . In addition , we left a part of the hemorrhoid intra-anally to reduce any impact on anal continence . We called this modification “ minimal open hemorrhoidectomy ” ( MOH ) . Material s and
Scores values tended to decrease postoperatively .
The comparison between haemorrhoidal treatments is still unclear .
Attempts have been made to adopt a unifying postoperative scoring system and thus ensure adequate comparison between clinical trials .
We aim ed to systematic ally review the available outcome scores of haemorrhoidal treatment .