A COMPARATIVE STUDY BETWEEN LASER HEMORRHOIDOPLASTY PROCEDURE VS OPEN HEMORRHOIDECTOMY IN THIRD AND FOURTH DEGREE HEMORRHOIDS.

Abstract

Haemorrhoids are common anorectal condition which can be dened as a symptomatic enlargement and distal displacement of normal anal cushion. It affects both gender and all ages equally and is believed to be caused by chronic constipation. Haemorrhoids affect the daily routine of the affected individual and common symptoms include rectal bleeding, pain, anal irritation and prolapse. Management of haemorrhoids can be divided into surgical and non-surgical methods and many techniques are used to treat haemorrhoids. All patients cannot be treated with only one procedure and in this study, we are comparing laser haemorrhoidoplasty with open haemorrhoidectomy technique. To compare the outcomes of Objectives: laser haemorrhoidoplasty versus open haemorrhoidectomy among patients presenting with second- and third-degree haemorrhoids. Methodology: A hospital based prospective cross-sectional comparative study design was adopted for our study and the source of our data were the patients attending surgery OPD at Navodaya Medical College with a clinical diagnosis of second and third degree haemorrhoids. Study duration was for 18 months and 80 was our sample size based on sample size calculation. who were recruited based on purposive sampling technique. Once recruited patients were randomly divided into two groups with 40 patients each and one group underwent laser haemorrhoidoplasty and another group underwent open haemorrhoidectomy. All the patients were followed up on day 0, day 1, day 2, day 7, one month and at 6 months postoperatively to record post-operative pain, return to work, wound infection, rectal bleeding and any other complications if encountered. All the ndings were compared between the groups to assess better technique with respect to various parameters included. Majority of the Results: patients were in the age group between 30 to 50 years and male predominance (76.25%) was seen. Bleeding and prolapse were the major complaints and 55% of them presented with 3rd degree haemorrhoids and 45% with 2nd degree haemorrhoids. Patients who underwent laser haemorrhoidoplasty had signicantly lesser duration of surgery, shorter hospital stay and less post-operative pain compared to open haemorrhoidectomy technique. Incidence of post-operative urinary retention, constipation, bleeding, sub-mucous abscess was slightly more among patients who underwent open haemorrhoidectomy compared to laser technique. Also, patient who underwent laser haemorrhoidoplasty returned to work earlier and had no recurrence, while patients who underwent open haemorrhoidectomy took more time to return to work and recurrence was seen in two patients. Laser haemorrhoidoplasty seemed to be Conclusion: better technique compared to open haemorrhoidectomy considering duration of surgery, required hospital stay, post-operative pain, post-operative return to work, constipation, bleeding and other complications. Laser technique had better outcome compared to open technique.