A Comparative Study Of Open Haemorrhoidectomy And Stapled Haemorrhoidopexy

ABSTRACT

ntroductionHaemorrhoidsor‘Piles’isafrequentlyobserveddiseaseinsurgicalpractice.Variousnon‐surgicalandsurgicaltreatmentsareavailable.Openhaemorrhoidectomy(Milligan‐Morgan)isawidelyusedprocedure.Arecentnoveltechniquecalled‘Stapledhaemorrhoidectomy’,firstdescribedandperformedbyItaliansurgeonAntonioLongoisgainingworldwiderecognitionforitsbenefits.Aim:TocompareStapledhaemorrhoidectomywithopen(MiliganMorgan)haemorrhoidectomyintermsofpost‐operativepain,resumptionofdailyactivity,hospitalstay,post‐operativebleeding,urinaryretentionandanalincontinence.StudyDesign:Prospective,comparativestudyfromAugust2017toAugust2018.MaterialsandMethods:Atotalof80patientsbetweentheagegroupof20and70years,diagnosedtohavegradeIIIorIVhaemorrhoidswereincludedinthestudy,dividedinto2groups,Group1undergoingOpenhaemorrhoidectomy(40patients)andGroup2undergoingStapledhaemorrhoidectomy(40patients).Postoperativelypatientsofbothgroupswerereviewedatthetimeofdischarge.Allpatientsweregivenaquestionnaireanddatacollectedverballyandanalysedstatistically.ComparativeanalysisbetweenthetwogroupsweredonebasedonIndependentstudents‘t’test.Results:ThemeanageofpatientsinOpenhaemorrhoidectomy(OH)groupwas42.2andStaplerhaemorrhoidectomy(SH)groupwas38.5.86.6%weremalesand13.4%werefemalesinOHgroup,90%weremalesand10%werefemalesinSHgroup.Post‐operativebleedinginbothOHandSHgrouphadanincidenceof2%.Post‐operativeurinaryretentionwasseenin4%and8%inOHandSHgrouprespectively.Inbothgroups,post‐operativeanalincontinencewasnotseen.BasedonIndependentsample‘t’testthepost‐operativepain,Post‐operativehospitalstayanddurationofresumptionofdailyactivitywaslessinSHgroupcomparedtoOHgroupandstatisticallysignificantwithp<0.001.However,complicationslikepost‐operativebleeding,urinaryretentionandanalincontinencearealmostsameinboththegroupsConclusion:StapledHaemorrhoidectomyislesspainfulwithshorterdurationofhospitalstayandresumptionofdailyactivityisfasterthantheopenhaemorrhoidectomy.However,longtermfollow‐upisrequiredtoknowtherecurrencerateinstapledhaemorrhoidectomy.