SUTURE HAEMORRHOIDOPEXY AND ITS SHORT-TERM OUTCOME
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 53
Abstract
BACKGROUND Since ancient times, haemorrhoids are known to be a common anorectal disease.[1] Many of the treatments have been widely practiced since old times. In India, this condition is associated with rural areas and low socio-economic status, hence the exact prevalence is not known. Patients usually neglect the disease because of fear to come in front of society with disease and also hesitate to take treatment for it. This leads to progression of the disease and it become more severe. [2] Patients who had failed medical treatment usually need surgical treatment.[3] Suture haemorrhoidopexy (Chivate’s procedure) now also called as mucorectopexy is a new surgery invented by an Indian surgeon for managing 2nd, 3rd, 4th grades of haemorrhoids with lesser incidence of pain. It is based on the principles of blocking of blood supply and preventing the neovascularization by plication of vessels in the rectum above dentate line at two different levels and anchoring the rectal mucosa & sub mucosa to Parks Ligament.[4],[5] The objective of the study is to evaluate Chivate’s new procedure of trans-anal mucorectopexy for 3rd and 4th degree haemorrhoids for pain, bleeding, hospital stay, recurrence and complications. MATERIALS AND METHODS It is an observational study. A total of 35 patients with grade 3 and grade 4 haemorrhoids (symptomatic with bleeding per rectum) underwent suture mucorectopexy procedure. The study was conducted at department of general surgery, SMIMER, Surat, wherein patients presenting to us with complaints of haemorrhoids were screened and patients with 3rd and 4th degree haemorrhoids and willing to undergo surgery were selected for this study. We had collected data of 35 patients with 3rd and 4th degree haemorrhoids and operated with this procedure. The sample size has taken for convenience. RESULTS Mean time required for procedure was 74.9 min. Mean duration of hospital stay was 4.42 days. Mean time to return to normal activity was 7.2 days. Average VAS score for post-operative pain at 24 hours was 5.5, at 72 hours was 3.4, at 7th day was 1.3, at 1 month was 0.3. Commonly reported complaints include, urinary retention- 34.2 % (n=12), pruritus ani- 8.5% (n=3), pain after operation requiring analgesic injections 8.5% (n=3), constipation 5.71% (n=2), bleeding PR 2.85% (n=1), rehospitalization due to urinary retention 2.85% (n=1). CONCLUSION Negligible recurrence rate on short term follow up along with lesser incidence of post-operative bleeding, minimal invasiveness with faster recovery or return to work will make Suture Haemorrhoidopexy a procedure of choice for grade II, III and IV haemorrhoids.
Authors and Affiliations
Dinesh Prasad, Kalariya Bhargav Jerambhai, Savan Jivani
Keywords
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- EP ID EP550532
- DOI 10.14260/jemds/2018/1244
- Views 72
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