Comparative Study between Stapled and Excision Haemorrhoidectomy for the Treatment of Haemorrhoids

Abstract

Introduction: There are different techniques for the treatment of hemorrhoidal diseases. Stapled haemrrhoidectomy is one of the modern technique which has shown little postoperative pain, less hospital stay and early go back to work. This study has been done to compare stapled haemorrhoidectomy with conventional excision hemorrhoidectomy. Methodology: The study was done in the Department of Surgery, Women’s Medical College Hospital and different private clinics in Sylhet District, from July 2016 to December 2017.A total of 42 patients were selected fulfilling the inclusion criteria to the stapled (n=21) and openexcision (n=21) group .Those patients having any other associated anal pathology like fistula, fissure, abscess and neoplasm were excluded from the study. Lithotomy position and spinal anesthesia were chosen for all the patients. Both the procedures were evaluated on the basis of total operative time, pain scores, complications, hospital stay and go back to work. Results: The mean age of patients was similar in both groups , that is 45.02 years (SD 12.30) in the stapled group and 47.54 years (SD13.50) in the open excision group.Male patients were more affected in both the groups ( 80.9%% in the stapled and 85.7% in the open group). Operative time was significantly less in the stapled group than in the open group (P .oo1). The blood loss, pain scores and requirement of analgesics was significantly less in the stapled group (P o.oo1). Average hospital stay was 2.20 days (SD 0.62) ) in the stapled group and 3.25 days (SD 1.01 ) days in the open group( P 0.01). Patients of the stapled group returned to work earlier (8.18days [SD2.24] as compared with 18.87 days [SD5.34] in the open group [P 0.001 ]). Maximum follow-up period was 6 months. Conclusions: Hemorrhoidectomy by stapled procedure is a safe and effective procedure for the treatment of grade II and grade III hemorrhoidaldieases. Early discharge and return to work are possible by this procedure. Furthermore, complications are as like as that of the open technique.