A Comparative Study of Open Haemorrhoidectomy and Stapled Hemorrhoidopexy

Indian Journal of Applied Basic Medical Sciences
Year: 2019, Volume: 21(B), Issue. (2)
First page: (91) Last page: (101)
Online ISSN: 2249-7935
Print ISSN: 0975-8917
doi:

A Comparative Study Of Open Haemorrhoidectomy And  Stapled Hemorrhoidopexy kaushal D Suthar1 and Shireesh Ninama2*
1
Associate Professor, 23rd Year Resident  dept Of  general Surgery, NHL Medical College and , SCL Hospital, Ahmedabad, Gujarat
Corresponding author email id: shireesh.ninama@gmail.com

Online Published on 02-Jul-2019

ABSTRACT

Introduction: Haemorrhoids or ‘Piles’ is a frequently observed disease in surgical practice. Various non‐surgical and surgical treatments are available. Open haemorrhoidectomy (Milligan‐Morgan) is a widely used procedure. A recent novel technique called ‘Stapled haemorrhoidectomy’, first described and performed by Italian surgeon Antonio Longo is gaining worldwide recognition for its benefits. Aim: To compare Stapled haemorrhoidectomy with open (Miligan Morgan) haemorrhoidectomy in terms of post‐ operative pain, resumption of daily activity, hospital stay, post‐operative bleeding, urinary retention and anal incontinence. Study Design: Prospective, comparative study from August 2017 to August 2018. Materials and Methods: A total of 80 patients between the age group of 20 and 70 years, diagnosed to have grade III or IV haemorrhoids were included in the study, divided into 2 groups, Group 1 undergoing Open haemorrhoidectomy (40 patients) and Group 2 undergoing Stapled haemorrhoidectomy (40 patients). Post operatively patients of both groups were reviewed at the time of discharge. All patients were given a questionnaire and data collected verbally and analysed statistically. Comparative analysis between the two groups were done based on Independent students ‘t’ test. Results: The mean age of patients in Open haemorrhoidectomy (OH) group was 42.2 and Stapler haemorrhoidectomy (SH) group was 38.5. 86.6% were males and 13.4% were females in OH group, 90% were males and 10% were females in SH group. Post‐operative bleeding in both OH and SH group had an incidence of 2%. Post‐operative urinary retention was seen in 4% and 8% in OH and SH group respectively. In both groups, post‐ operative anal incontinence was not seen. Based on Independent sample ‘t’ test the post‐operative pain, Post‐ operative hospital stay and duration of resumption of daily activity was less in SH group compared to OH group and statistically significant with p<0.001. However, complications like post‐operative bleeding, urinary retention and anal incontinence are almost same in both the groups Conclusion: Stapled Haemorrhoidectomy is less painful with shorter duration of hospital stay and resumption of daily activity is faster than the open haemorrhoidectomy. However, long term follow‐up is required to know the recurrence rate in stapled haemorrhoidectomy.

Keywords

Haemorrhoids, Haemorrhoidopexy, Staple

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