Management Of 3rd Degree Hemorrhoids With Stapled Haemorrhoidectomy Vs. Open Haemorrhoidectomy: A Prospective Randomized Study.

Indian Journal of Applied Basic Medical Sciences
Year: 2019, Volume: 21(B), Issue. (2)
First page: (149) Last page: (153)
Online ISSN: 2249-7935
Print ISSN: 0975-8917
doi:

Management Of 3rd Degree Hemorrhoids With Stapled Haemorrhoidectomy Vs.  Open Haemorrhoidectomy: A Prospective Randomized Study.  
Aakash G Rathod1 and Shaishav Patel2*
1Assistant Professor, 2Assistant professor, Department of General Surgery, AMC MET  medical college and LG Gen Hospital Maninagar Ahmedabad pin 380008 Corresponding author email id: haishav.ptl@gmail.com*
 aakash.rathod@gmail.com1

Online Published on 02-Jul-2019

ABSTRACT

Introduction: Many surgical and non‐surgical treatment modalities are available for management of hemorrhoids of which Haemorrhoidectomy is regarded as the gold standard of treatment. Conventional open Haemorrhoidectomy is widely performed & has stood the test of time. Stapled Haemorrhoidectomy is newer procedure in the management of haemorrhoids. Our study aims to compare the two surgical modalities in relation to the technique & time duration of surgery, post‐ operative stay & complications. Methods: A prospective randomized study was conducted at AMC MET MMC & LG hospitals Ahmedabad between 1st January 2016 & 1st Sept 2016. All patients presenting with 3rd degree haemorrhoids were randomized between Open & Stapled Haemorrhoidectomy groups & compared with relation to mean operative timing, complications post operatively namely hemorrhage, urinary retention & post‐operative pain, duration of hospital stay, duration for resuming normal work after discharge. All cases were thoroughly studied and followed up for period of 3 months. Data was assessed by multi‐ variation analysis by paired T test & Wilcoxon analysis.
Results: The mean operative time, postoperative pain, hemorrhage & incidence of urinary retention were found significantly less in stapled haemorrhoidopexy group compared to open surgery group. Mean duration of Hospital stay was 3 days and returned to their routine work in 10 days in stapled haemorrhoidopexy group which was 6 days & 17 days for open surgery group respectively. Conclusion: Stapled haemorrhoidopexy is effective in terms of decreased /minimal pain, less requirement of analgesics and less pain at first bowel movement, less post‐operative recovery time which indicate faster wound healing, & short postoperative hospital stay with early return to normal routine activity. However, long‐term follow‐up is necessary to determine whether these initial results are reproducible & both procedure need to be evaluated for many other variables such as cost effectiveness, intra operative blood loss & recurrence before coining stapled Haemorrhoidectomy as a standard procedure for management of 3rd degree haemorrhoids.

Keywords

MIPH, Stapled haemorrhoidopexy, Haemorrhoidectomy.

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