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Comparative Study of Minimal Invasive Procedure for Haemorrhoids vs Conventional Haemorrhoidectomy in Management of Haemorrhoids

Vipul Gurjar, Associate Professor, Dept of Surgery, Smt. B.K. Shah Medical Institute & Research Center, Sumandeep Vidyapeeth, Vaghodia, Gujarat 391750, India. , Chirag Parikh1 , Vipul Gurjar2 , Devarshi Trivedi3

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New Indian Journal of Surgery 9(4):p 516-523, July - August 2018. | DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9418.23

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Abstract

Introduction: Till recently Milligan – Morgan haemorrhoidectomy i.e. conventional or open haemorrhoidectomy is the most popular surgical treatment for haemorrhoids. With the advent of minimal invasive surgery, the scenario has changed. More recently, stapler haemorrhoidectomy is becoming popular as a day care procedure with minimal postoperative pain and early return to work.

Aim: The present study is designed to compare make a comparative assessment of the Stapled haemorrhoidectomy against Conventional haemorrhoidectomy in the surgical treatment of haemorrhoids.

Material and Methods: A hospital based Non­randomised comparative study was conducted in Dept. of Surgery of at a tertiary care hospital. A total of 50 eligible cases scheduled for haemorrhoidectomy in our hospital were included in the study. These 50 patients were then divided into two groups i.e. 25 for stapled procedure and other 25 patients for conventional procedure.

Results: Mean operative time was significantly less in stapler group (39.12 vs 45.75 mins; p<0.01) while mean hospital stay was significantly longer in conventional surgery group (7.02 vs 3.01 days; p<0.01). Post­op complain of pain, immediately after surgery (6 hrs.) and at day 1 and day 3 was significantly less in stapler group (p<0.01). Postop complications after conventional surgery include bleeding (28%), urinary retention (12%), wound infection, anal incontinence (8% each) and anal stenosis  (4%). Complications of stapler surgery include bleeding (16%) and urinary retention (4%). Mean time for return  to work was significantly less in stapler group as compared to conventional surgery group (4.91 vs 13.8 days; p<0.01).

Conclusion: Stapler haemorrhoidectomy requires less operative time, reduces hospital stay and decreases post­operative pain. Return to normal activity is also significantly faster with stapler surgery. 

Keywords: Conventional Haemorrhoidectomy; Haemorrhoids; Stapler Haemorrhoidectomy; Postoperative Pain; Return to Work.

 

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DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9418.23

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