Stapled Versus Open Haemorrhoidectomy- Evaluation of Short Term Results

• Main Authors: Srikanth Kulkarn, Manohar Shivamalavaiah, Rajkumar Janvikulam Sankaran, Anirudh Janvikulam Rajkumar
• Format: Article
• Language: English
• Published: JCDR Research and Publications Pvt. Ltd. 2016-07-01
• Series: International Journal of Anatomy Radiology and Surgery
• Subjects: anal incontinence; haemorrhoids; hospital stay; post operative bleeding; post operative complications; urinary retention
• Online Access: http://www.ijars.net/articles/PDF/2142/19403_F(P)_PF1(VsuGH)_PFA(GH)_PF2(VsuGH).pdf
• ISSN: 2277-8543; 2455-6874

Introduction: Haemorrhoids or ‘Piles’ is a frequently observed disease in surgical practice. Various non surgical and surgical treatments are available. Open haemorrhoidectomy (Milligan-Morgan) is a widely used procedure. A recent novel technique called ‘Stapled haemorrhoidectomy’, first described and performed by Italian surgeon Antonio Longo is gaining worldwide recognition for its benefits. Aim: To compare Stapled haemorrhoidectomy with open (Miligan Morgan) haemorrhoidectomy in terms of post operative pain, resumption of daily activity, hospital stay, post operative bleeding, urinary retention and anal incontinence. Study Design: Prospective, comparative study from August 2011 to September 2013. Materials and Methods: A total of 100 patients between the age group of 20 and 70 years, diagnosed to have grade II, III or IV haemorrhoids were included in the study, divided into 2 groups, Group 1 undergoing Open haemorrhoidectomy (50 patients) and Group 2 undergoing Stapled haemorrhoidectomy (50 patients). Post operatively patients of both groups were reviewed at the time of discharge, at 7 days after discharge, at 1 month and 3 months post surgery. All patients were given a questionnaire and data collected verbally and analysed statistically. Comparative analysis between the two groups were done based on Independent sample ‘t’ test or students ‘t’ test using a SPSS version 20. Results: The mean age of patients in Open haemorrhoidectomy (OH) group was 40.68 and Stapler haemorrhoidectomy (SH) group was 39.52. 78% were males and 22% were females in OH group, 90% were males and 10% were females in SH group. Post operative bleeding in both OH and SH group had an incidence of 2%. Post operative urinary retention was seen in 4% and 8% in OH and SH group respectively. In both groups, post operative anal incontinence was not seen. Based on Independent sample ‘t’ test the post operative pain, Post operative hospital stay and duration of resumption of daily activity was less in SH group compared to OH group and statistically significant with p<0.001. However, complications like post operative bleeding, urinary retention and anal incontinence are almost same in both the groups. Conclusion: Stapled Haemorrhoidectomy is less painful with shorter duration of hospital stay and resumption of daily activity is faster than the open haemorrhoidectomy. However, long term follow-up is required to know the recurrence rate in stapled haemorrhoidectomy.