ABSTRACT
Objective: to compare the postoperative outcome of stapled haemorrhoidectomy and conventional Milligan Morgan's haemorrhoidectomy at Allied Hospital
Study Design: simple comparative study
Place of Study: Surgical Unit 1, Allied Hospital Faisalabad
Duration of Study: January 2011 to September 2012
Sample size: 50 patients
Material and Methods: fifty patients of 3rd and 4th degree hemorrhoids were selected for admission from the outpatient department. Patients with additional anal disease [e.g. fissure, abscess, fistula, ano-rectal cancer etc.] were excluded. Two groups of twenty five each were made. Group A for stapled haemorrhoidectomy and Group B for Milligan- Morgan haemorrhoidectomy [MMH]. The operative time was measured in minutes. Postoperative pain was assessed through visual analogue scale [VAS]. Bleeding was measured as mild, moderate and profuse. Other postoperative complications during hospital stay like urinary retention, anal stenosis etc. were noted. T-test, chi-square test and repeated measured analysis of variance were applied to compare the variables
Results: a majority of patients[combined in both groups] had third degree haemorrhoids. The mean length of operative time was found statistically insignificant between stapled and open groups [34 vs 36 minutes]. In Group A 23 [92%] patients were discharged in 24 hrs while 2 [8%] patients were discharged after 24 hrs. In Group B 9 [36%] patients were discharged in 24 hrs and 16 [64%] patients were discharged after 24 hrs. In group A 19 [76%] patients were having mild bleeding, 5 [20%] moderate bleeding and 1 [4%] profuse bleeding. In Group B 7 [28%] patients were having mild, 16 [64%] moderate and 2 [8%] profuse bleeding. In Group A 15 [60%] patients were having mild pain, 7 [28%] moderate and 3 [12%] severe pain on visual analogue scale. In Group B 4 [16%] patients were having mild pain, 15 [60%] moderate and 6 [24%] severe pain. The proportion of postoperative anal stenosis, prolapsed recurrence, persistent pain, recurrent bleeding and urinary retention was higher in MMH than stapled haemorrhoidectomy group
Conclusion: there was a significant difference between stapled haemorrhoidectomy and Milligan Morgan's for bleeding, pain and hospital stay. However the mean length of operative time was insignificantly different