Comparison of Stapled Hemorrhoidopexy and Open Hemorrhoidectomy — A Study in a District Level & a Tertiary Care Hospital

Résumé

Introduction:  Hemorrhoids are usually managed by hemorrhoidectomy which is associated with postoperative pain, long hospital stay, and a longer convalescence. Stapled hemorrhoidopexy is a newer alternative for the treatment of hemorrhoids. This study aimed to analyze the outcome in patients of both procedures. Methods and materials: This cross-sectional study was conducted at the Department of Surgery at Ibn Sina Medical College Hospital in Kallyanpur, Dhaka, Bangladesh; a tertiary care hospital and in a district-level hospital. All necessary data were collected during and after the surgery. Data were entered using SPSS software. Informed written consent was taken from all patients and all data were kept confidential. Result: In the present study, duration of surgery was 35±5 min in Group A, while 25±10 min in Group B. patients of Group A needed 9.5 hours to return to normal bowel function whereas it was 12 hours in Group B. Patients of Group A experienced comparatively less pain than the patients of Group B. Hospital-stay was much shorter (1.5 days) in cases of Group A patients while longer (2±1) in Group B patients. Postoperative bleeding was also less in Group A. Recurrence rate of the disease was much higher (5.7%) in Group A than Group B (1.0%). Conclusion: This study concludes that, although stapled hemorrhoidopexy is widely used, the long-term outcome is limited. Stapled hemorrhoidopexy offers the benefits of less postoperative pain, less requirement for analgesics, and less pain at first bowel movement, while the chance of recurrence of hemorrhoid is much higher.