A study of radiofrequency ablation versus milligan morgan haemorrhoidectomy for the treatment of grade III hemorrhoids
Journal Title: Medpulse International Journal of Surgery - Year 2017, Vol 3, Issue 3
Abstract
Background: Development in the treatment of haemorrhoidal disease over the last 20 years has moved towards less invasive and non-ablative surgery. Several new techniques have been developed, but the use of these techniques in clinical practice and the general management of patients with haemorrhoidal disease. Aims and Objective: To study effectiveness of Radiofrequency Ablation versus Milligan Morgan Haemorrhoidectomy for the Treatment of Grade III Hemorrhoids. Methodology: After approval form the institutional ethical committee a prospective clinical trial on the 40 patients Diagnosed as of Grade III hemorrhoids during January 2014 to January 2015 was carried out at the tertiary care hospital, written consent of the patients were taken. All eligible Grade III hemorrhoids patients were given treatment by Milligon –Morgan Haemorrhoidectomy (Group B). An Ellman Dual 4 MHz radiofrequency generator was used for the Radiofrequency ablation and Plication of haemorrhoids (Group A). The eligible patients for the surgeries were randomly allocated to the Group A (20 patients) and Group B (20 patients) by computer generated random numbers. The statistical analysis done by Un-paired t-test by Graph Pad Prism 5 software. Result: The difference in two groups of the average age is comparable (P>0.05;t = 1.114;df=38.); Operative time was significantly lower in Group A compared to Group B(P< 0.0001 ;t = 10.00; df=38.) ; Intra-operative bleeding was significantly lower in Group A compared to Group B (P< 0.0001 ; t = 41.1437 df=38); Time to first bowel movement (hr) was significantly lower in Group A compared to Group B (P<0.0001; t = 14.10;df=38); Average hospital stay (Days) was significantly lower in Group A compared to Group B (P<0.0001; t = 4.00 ;df=38); Average Analgesic required (No. of Tab.) was significantly lower in Group A compared to Group B (P<0.0001;t=15.81 ;df=38). Time required for Wound healing (Days) was significantly lower in Group A compared to Group B (P<0.0001; t=10.73;df=38). Overall the complications were, more in the Group B (35%) (Milligan Morgan Haemorrhoidectomy) as compared to Group A (10%) (Radiofrequency Ablation). The complications like Urinary retention, Bleeding, Incontinence of flatus, External tags, Recurrence, Anal stenosis, were common in Group B than Group A. Conclusion: Overall the operative outcomes like less intraoperative bleeding, less time for the first bowel movement with less analgesic were better in Radiofrequency Ablation and overall complications were less in Radiofrequency Ablation compared to conventional Milligan Morgan Haemorrhoidectomy.
Authors and Affiliations
Jayesh Shaligram Khadse, Sachin Shashikant Ingale
Keywords
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