ABSTRACT
Background: Haemorrhoids are one of most common benign anorectal malformation worldwide. There are various surgical treatment modalities for 3rd and 4th degree haemorrhoids. Open haemorrhoidectomy was the most widely practiced and is considered the current gold standard. In search of a newer surgical technique, stapler has been introduced for haemorrhoidectomy and has revolutionised operative procedures over the last decade world-wide due to its ease and simplicity and lesser post-operative complications. The following study was done to evaluate the outcome of open versus stapled haemorrhoidectomy in terms of post-operative pain, postoperative bleeding, duration of surgery, duration of hospital stays in a medical college hospital at Raipur, Chhattisgarh.Methods: This was a prospective follow-up study, in patients undergoing surgery for grade III/IV haemorrhoids conducted in the Department of Surgery, Dr BRAM Hospital, Raipur, from August 2017 to July 2018. Fourteen patients underwent stapled haemorrhoidopexy and eighteen underwent open haemorrhoidectomy. All patients were reviewed immediately after surgery, at discharge and at 1, 3 and 10 weeks post-operatively. The two groups were compared for post-operative outcomes and complications.Results: The majority of patients in the study were males and had grade 4 haemorrhoids. Stapled haemorrhoidopexy group had shorter duration of surgery, less postoperative pain, shorter duration of hospital stays as compared with open haemorrhoidectomy group. There were no major post-operative complications in the follow up period of 10 weeks in the stapled group.Conclusions: Stapled haemorrhoidopexy is a safer alternative to open haemorrhoidectomy with many short-term benefits.
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
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.