Stapled Haemorrhoidopexy in India– Worthy of Its Cost?
Journal Title: Scholars Academic Journal of Biosciences - Year 2017, Vol 5, Issue 3
Abstract
Hemorrhoids are one of the commonest anorectal disorders, being treated commonly by conventional hemorrhoidectomy. Stapled haemorrhoidopexy is usually reserved for 3rd and 4th degree haemorrhoids and sometimes for 2nd degree haemorrhoids as well. In Indian scenario, the disease continues to be neglected by the patients as well as clinicians and often the patients obtain proper treatment after considerable suffering. Although it has been widely practiced in India for more than a decade; it still lacks universal acceptance and popularity predominantly due to its cost. Forty nine patients remaining undergo stapled haemorrhoidopexy. Adverse outcomes were assessed at each of the follow up visits (15 days, 1 month, 6 months and 12 months) in the form of a questionnaire concerned recurrence of symptoms, symptoms related to continence and defecatory disorders. The post-operatively pain was assessed using Visual Analogue Scale and the time taken for resumption of activities of daily living using (ADLs) which was evaluated using the Katz Index of Independence in Activities of Daily Living. For patient satisfaction, Quality of life (QOL) assessment was done by WHO Quality of Life-BREF (WHOQOL-BREF) questionnaire. It was also asked whether they found the procedure to be cost effective or not and would the patients recommend this procedure to others. The median score for overall perception of QOL which was 50 (IOR 45-55) pre-operatively increased to 85 (IOR 80-85) one year after surgery for these patients. Similarly the score for overall perception of health was 50 (IOR 50-55) pre-operatively, which increased to 80 (IOR 80-85) one year after surgery thereby proving that quality of life had been improved a lot. Regarding cost, thirty five (71.4%) patients rated the procedure as costly though 44 (89.8%) patients accepted it cost effective and 44(89.8%) out of 49 reported that they would like to recommend it to others.
Authors and Affiliations
Anshuman Pandey, Shakeel Masood, Smita Chauhan, Alankar Gupta, Manish Raj Kulshrestha
Keywords
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