RESUMO
Haemorrhoids are the cushions of the tissue within the anal canal that contain blood vessels and their surrounding supporting tissue made up of muscle and elastic fibres. It is classified into four degrees. 1st degree haemorrhoids bleed but do not prolapse, 2[nd] degree haemorrhoids prolapse on defaecation and reduce spontaneously, 3[rd] degree haemorrhoids prolapse on defaecation and require manual reduction and 4[th] degree haemorrhoids remain permanently prolapsed. Haemorrhoids may cause symptoms including bleeding, soiling, discharge, itching, prolapse and pain if haemorrhoids are thrombosed
Methodology: This Quasi experimental study was carried out in the Department of General Surgery at Lahore General Hospital, Lahore. A total of 190 patients with 3[rd] and 4[th] degree haemorrhoids were enrolled and divided in two equal groups i.e. 95 group A [stapled haemorrhoidectomy] and 95 group B [closed haemorrhoidectomy]
Results: Among 95 patients in group A, 59 were male and 36 female patients with a mean age of 41.36 years and in group B, 55 male and 40 female patients, with a mean age of 41.33 years. The mean duration of hospital stay was 1.09 days in group A and 2.16 days in group B and p value 0.000. The mean operative time was 23.25 minutes in group A and 43.13 minutes in group B with a p value 0.000. Minor complications were occurred in group A in 8 patients [8.4%]. Post operative pain was significantly lower in group A and pain was significantly high in group B. Mean return to work in group A was 7.38 days and in group B was 16.67 days
Conclusion: Stapled haemorrhoidectomy compared to closed haemorrhoidectomy offers less post operative pain, shorter hospital stay, less operative time and earlier return to work. Stapled haemorrhoidectomy is a costly procedure for the patient and rate of recurrence after stapled haemorrhoidectomy are higher than closed haemorrhoidectomy but in our follow up of four months no recurrence was noted in either group