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A Prospective Comparative Randomized Study between Stapled and Conventional Haemorrhoidectomy

Amit Singh, Assistant Professor, Department of General Surgery, J.L.N Medical College Ajmer, Rajasthan 305001, India , Anil Kumar Sharma1 , Satyaveer Singh2 , Rekha Porwal3 , Amit Singh4 , Mukesh Kumar5 , Pema Ram Khichar6

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New Indian Journal of Surgery 9(5):p 579-586, Sep-Oct 2018. | DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9518.7

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Abstract

Aims & Objectives: In the present study we have compared between recent stapled  haemorrhoidectomy  and conventional haemorrhoidectomy (Milligan Morgan Technique) for treatment of haemorrhoids in terms of operating time, postoperative pain and bleeding and other complications, hospital stay and time to return  to work. Materials & Methods: This is a prospective comparative study conducted in the department of general surgery of J.L.N.Medical College, Ajmer, Rajasthan in the duration of November 2015 to December 2017. Sixty (60) patients of age>20 years with symptomatic internal hemorrhoids of 3rd & 4th degree were randomly assigned to either conventional or stapled haemorrhoidectomy (30 in each group). Visual analog scale was used for evaluation of pain. Intraoperative blood loss, procedure time, postoperative pain and other complications like urine retention, bleeding, infection, constipation and recurrence rate were studied. Postoperative hospital stay duration, days required to resume normal bowel habits and normal daily activities and satisfaction with treatment. Follow up was done at 1 week, 1 month and 3 month. Data collected and analyzed. Results: Intra-operative blood loss (70.33 v/s 30.33 ml, p value<0.01), duration of surgery (32.8 v/s 27.1 minutes, p value <0.01), post operative pain (p value <0.01) and hospital stay (2.2 v/s 1.0 days, p value<0.001) were less in stapled haemorrhoidectomy. Earlier normal bowel habits (3.6 v/s 2.2 days, p value <0.01) and earlier resumption of normal personal activities (5.6 v/s 4.2 days value <0.001) and better patient satisfaction  (53.33% v/s 93.33%, p value < 0.001) were associated with stapled haemorrhoidectomy. Results regarding post operative complications like bleeding, urinary retention, infection and constipation were no statistical difference found (p value >0.05). Conclusion: Stapled haemorrhoidectomy procedure is superior to conventional haemorrhoidectomy in terms of intra operative blood loss, operative time, post-operative pain, first defecation, early resumption of activity, hospital stay and patient‘s satisfaction. Regarding anal stenosis and recurrence rate long term follow-up is necessary. 

Keywords: Anal Stenosis; Haemorrhoids; Post Operative Complications; Recurrence; Urinary Retention.  

 

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DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9518.7

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