ABSTRACT
Background: Haemorrhoids are one of the most common benign anorectal problems worldwide. The treatment of thirdand fourth-degree haemorrhoids is surgical. Surgical haemorrhoidectomy and Stapled haemorrhoidopexy are the currently available surgical interventions in the management of haemorrhoids. The aim of the study is to evaluate the effectiveness of open haemorrhoidectomy with minimal invasive procedure for haemorrhoids (MIPH). Methods: 80 cases were selected for this study which were divided into two groups of 40 each. Open surgery (Milligan-morgan haemorrhoidectomy ) was done in one group and MIPH in the other group .The follow up period was one year. The duration of post. operative pain, complications, level of satisfaction was documented. The relative merits and demerits of the procedures were assessed and the results documented.Results: MIPH is a safe and effective procedure in patients presenting with haemorrhoids .Duration of hospital stay is less and hence return to work is earlier. Conclusion: MIPH can be considered as a procedure of choice in patients presenting with grade II,grade III and grade-IV haemorrhoids.
ABSTRACT
Haemorrhoids are dilated veins which descend down to the anus present as pain during defaecation, bleeding and a protruding mass outside the anus. The aim of the study is to evaluate the effectiveness of open haemorrhoidectomy with minimal invasive procedure for haemorrhoids (MIPH). Methods: 60 cases were selected for this study .30 patients each were divided into two groups.Open surgery ( Milligan-morgan haemorrhoidectomy ) was done in one group and MIPH for the other group .The follow up period was one year .The duration of post. operative pain, complications, level of satisfaction was documented . The relative merits and demerits of the procedures were assessed and the results documented. Results: MIPH is a safe and effective procedure in patients presenting with haemorrhoids .Duration of hospital stay is less and hence return to work is earlier. Conclusion: MIPH can be considered as a procedure of choice in patients presenting with grade II, grade III and grade-IV haemorrhoids.
ABSTRACT
ABSTRACT Minimally invasive procedure for hemorrhoids is one of the commonest new wave operations done for prolapsed hemorrhoids. The diameter of the stapled tissue is critical in this operation, and an increase in the same could include more tissue in the anvil, with disastrous results. This is a case report of a post minimally invasive procedure for hemorrhoids bleed, which was refractory to two local oversewing attempts. When the bleeding was massive, an angiogram was obtained. This revealed a pseudo aneurysm of the left superior haemorrhoidal artery, which was embolized, stopping the bleed. The stapler dimensions were studied and the possible cause of the event was arrived at. The specific stapler used had a diameter of 2 mm more than the regular Medtronic and Ethicon staplers, possibly including more of the rectal wall, and the superior haemorrhoidal artery as well. This case report documents a rare and potentially fatal complication of a simple procedure.
RESUMO O procedimento minimamente invasivo para as hemorroidas (PMIH) é uma das novas operações mais comuns para ao tratamento de hemorroidas prolapsadas. O diâmetro do tecido grampeado é crítico nessa operação; um aumento nesse diâmetro poderia colocar mais tecido na bigorna do grampeador, com resultados desastrosos. Este relato de caso descreve o desfecho de uma hemorragia após PMIH, refratária a duas tentativas locais de sobressutura. Um angiograma foi realizado quando a hemorragia foi considerada intensa. O exame revelou um pseudoaneurisma da artéria hemorroidária superior esquerda, que foi embolizada, interrompendo o sangramento. As dimensões do grampeador foram estudadas e descobriu-se a possível causa do evento. O grampeador específico usado tinha um diâmetro 2 mm maior do que os grampeadores regulares da Medtronic e da Ethicon e possivelmente captou uma área maior da parede retal e a artéria hemorroidária superior. Este relato de caso documenta uma complicação rara e potencialmente fatal de um procedimento simples.
Subject(s)
Humans , Male , Adult , Minimally Invasive Surgical Procedures , Hemorrhoids/surgery , Prolapse , Surgical Staplers , Aneurysm, False , HemorrhageABSTRACT
METHODS:Prospective Comparative Study conducted on 60 patients at Santosh Medical College and Hospital, Ghaziabad. 30 patients underwent Longo technique of MIPH and rest 30 underwent Milligan Morgan technique of Open haemorrhoidectomy. Study aimed at comparing the duration of surgery, post-operative pain, analgesia requirement, duration of hospital stay, post- operative complications and the amount of days taken for return to work. RESULTS:Mean duration of surgery was 25.90+-4.21 min and 46.73+-5.10 min in MIPH and Open haemorrhoidectomy group respectively ,P<0.001. Patients undergoing MIPH had lesser VAS Pain score on postoperative day 0,1, 7 and analgesia requirement ,p<0.001. No patients in the MIPH group had residual prolapse, p<0.001.Time needed to return to work was 4.70 ± 0.83 days and 12.10 ± 2.71 days in MIPH and Open haemorrhoidectomy group respectively, p<0.001. CONCLUSIONS:MIPH is relatively faster procedure, lesser postoperative pain and analgesia requirement, faster return of bowel movements and earlier return to work.