Comparison between Lord Dilitation Versus Lateral Internal Sphincterotomy for Management Post Hemorrhoidectomy Pain and Stenosis

Abstract

Hemorrhoidectomy is usually associated with significant pain during the postoperative period. The spasm of internal sphincter seen to play an important role in the origin of pain. This study was designed to evaluate the effectiveness of lateral internal sphincterotomy or Lord dilatation of anal sphincter after hemorrhoidectomy in regarding the maximum resting pressure of the anal canal, accelerating wound healing and decrease postoperative pain when resting and defication. The patients with profound or diagnosed hemorrhoid (n = 79), visited to the Alfayha teaching hospital during April 2016 to June 2017 were enrolled in the present study. The informed consent was taken from each patient before enrollment. Seventy nine patients were admitted in the hospital complaining from anal stenosis and pain after different method of hemorrhoidectomy. The patients underwent hemorrhoidectomy with unhealed wound and severe pain after defication one month ago. They were divided into the two groups viz. patients treated with lateral internal sphincterotomy (n = 40) or lord dilatation surgery (n = 39). In the present study the ratio of lateral internal sphincteroctomy to lords dilatation surgery were found to be 2.761. The occurrence of the hemorrhoid was found to be higher in male than females (2.95:1). The higher number of patients were from 21-30 age group. About 69.2% of male patients ere operated by lord dilatation, while 33 (82.5%) of male patients managed by lateral internal sphinctertomy. Around 12 females (30.8%) managed by lord dilatation and 7 (17.5%) female patients managed by lateral internal sphincterotomy. Out of total patients, 43 were suffering from diabetes mellitus where, 16 were operated by the lard dilation and 27 were operated with lateral internal sphincterotomy. Around 22 suffering steroid problem out of which 17 were operated by the lard dilation and 5 were operated with lateral internal sphincterotomy. About 3 patients were suffering malignancy (2 in lard dilation and 27 in lateral internal sphincterotomy surgery). The present study concluded that the lord dilatation is significant improve wound healing after hemorrhoidectomy and decrease pain.