ABSTRACT
Introduction: Hemorrhoids are one of the most frequent anorectal disorders encountered by clinicians in day-to-day practiceand constitute about 50% of colorectal investigations. Stapled hemorrhoidopexy (SH) represents the first dramatic change inthe treatment of hemorrhoids. Since its introduction, some researchers have raised concerns about the recurrence rate as wellas patient satisfaction. Hence, the present study was carried out to evaluate recurrence rate and patient overall satisfactionwith SH procedure at a tertiary care center in North India.Materials and Methods: Ethical clearance was obtained at the start of the study from the Institutional Review Board. A totalof 100 patients with Grade III/IV hemorrhoids were included. SH was performed as per the standard procedures. Data werecollected on complications developed post operatively at different follow-ups and an overall patient satisfaction. The data werecoded and entered into Microsoft Excel 2010.Results: Post-operative complications we observed at the 1st week were bleeding and discharge in 5%, pain in 9%, and urinaryretention in 11% of enrolled cohorts. At 1 month, hematoma formation was observed in 7.3% of total remaining patients (n = 96)and 5.2% still had post-operative pain. At 6 months, pruritus and stenosis were witnessed in 4.3% and 1.1%, respectively, oftotal remaining patients (n = 93). Recurrence rate was found 4.3% at the end of 6 months. The overall complication rates at 1week, 1 month, and 6 months follow-up were 25%, 12.5%, and 9.7%, respectively.Conclusion: The findings of our study confirm that SH is associated with a high patient satisfaction and with a lesser postoperative complications. We conclude that SH is safe with many short-term benefits.
ABSTRACT
Introduction: Hemorrhoid disease therapy is effectively been treated with conventional excisional hemorrhoidectomy. Stapledhemorrhoidopexy (SH) revolutionized the traditional surgical approach by the introduction of the theory of dealing with the rectalmucosal prolapse by resecting a mucosal cylinder above the dentate line by means of mechanical stapling. It is a non-excisionalapproach for the surgical treatment of hemorrhoid disease.Materials and Methods: Ethical clearance was obtained from the institution. A total of 100 adult patients with Grade III/IVhemorrhoids indicated for surgery were recruited for the study purpose. Data collected were post-operative pain in the form ofVAS scale, immediate complications, duration, or length of stay in the hospital along with the time to resume work again. SPSS17.0 was used to carry out the analysis. All P < 0.05 were considered to be statistically significant.Results: The mean age of the study group was 45 ± 14.93 years. The mean length of hospital stays, postoperatively for 21%subjects, was mere 1 day; however, it was 2 days for the rest of population studied. The only complication was with 2% of thestudy population having excessive intraoperative bleeding. The mean time to return to work was 8 days. About 77% of thepatients resumed their work within 8 days of surgery.Conclusion: Within the given limitations of the study, we can conclude that SH is a successful procedure for Grade-III/IVhemorrhoids in terms of immediate post-operative complications, pain as well as the duration of hospital stay