A COMPARATIVE STUDY OF OPEN HAEMORRHOIDECTOMY VS STAPLED HAEMORRHOIDOPEXY

Abstract

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 2017 to August 2019.

 Materials and Methods: A total of 80 patients between the age group of 20 and 70 years, diagnosed to have grade III or IV haemorrhoids were included in the study, divided into 2 groups, Group 1 undergoing Open haemorrhoidectomy (40 patients) and Group 2 undergoing Stapled haemorrhoidectomy (40 patients). Post operatively patients of both groups were reviewed at the time of discharge. 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.

 Results: The mean age of patients in Open haemorrhoidectomy (OH) group was 42.2 and Stapler haemorrhoidectomy (SH) group was 38.5. 86.6% were males and 13.4% 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