OPEN HAEMORRHOIDECTOMY VERSUS STAPLED HAEMORRHOIDOPEXY- A PROSPECTIVE STUDY IN A TERTIARY HOSPITAL IN SOUTH INDIA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 52
Abstract
BACKGROUND Haemorrhoids are one of the most common benign anorectal problems worldwide. The treatment of third- and fourth-degree haemorrhoids is surgical. Surgical haemorrhoidectomy and Stapled haemorrhoidopexy are the currently available surgical interventions in the management of haemorrhoids. The present study is designed to compare the short-term outcomes of Stapled haemorrhoidopexy with Milligan-Morgan (Open) Haemorrhoidectomy. MATERIALS AND METHODS This was a prospective and comparative study done among 90 patients admitted in surgical ward of SRM Medical College, Hospital and Research Centre, Kattankulathur between 2014 and 2015. Forty five patients underwent Open Haemorrhoidectomy (OH) and 45 patients underwent Stapled Haemorrhoidopexy (SH). The duration of surgery, postoperative pain and immediate postoperative complications between OH (Open Haemorrhoidectomy) and SH (Stapled Haemorrhoidectomy) were compared. Statistical significance was tested by Chi-square test, student’s ‘t’ test, Mann-Whitney ‘U’ test and Fisher Exact Test. RESULTS In this study, among 90 study participants 57 were males and 33 were females. The mean duration of surgery was 35 minutes ranging from 25 to 55 minutes in Stapled Haemorrhoidopexy (SH) and the mean duration of surgery was 46 minutes ranging from 25 to 55 minutes in Open Haemorrhoidectomy (OH). Duration of surgery is significantly low in stapled group (p < 0.001). The pain was assessed using a Visual Analog Scale (VAS). The pain score was below 3 in patients who underwent Stapled Haemorrhoidopexy (SH) and significantly higher in patients who underwent Open Haemorrhoidectomy at 6 hrs. (p < 0.001), 12 hrs. (p < 0.05) and 24 hrs. (p < 0.01). The immediate post-operative pain is significantly less in Stapled Haemorrhoidopexy (SH) group (28.9%) than the Open Haemorrhoidectomy (57.8%) (p < 0.01). CONCLUSION The findings of our study confirm that patient who underwent Stapled Haemorrhoidopexy (SH) is associated with shorter duration of surgery, less postoperative pain and minimal immediate post-operative complication. We conclude that Stapled Haemorrhoidopexy (SH) is safe with many short-term benefits.
Authors and Affiliations
Rajesh Daniel, Reegan Jose M, Floret S, Paneerselvam Paneerselvam, Jeyakumar Jeyakumar, Mohamed Mustafa, Baskaran Selvapathy
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