Comparison of Open Haemorrhoidectomy and Stapled Haemorrhoidopexy: A Hospital- based Prospective Study

Abstract

Introduction: Open Haemorrhoidectomy (OH) is a widely used procedure. While as a novel technique, Stapled Haemorrhoidectomy (SH) is gaining worldwide recognition for its benefits, regarding treatment procedures for Haemorrhoids or piles. Aim: To compare SH technique with OH technique on the basis of postoperative parameters including pain, resumption of daily activity, hospital stay, postoperative bleeding, urinary retention and anal incontinence. Materials and Methods: This hospital-based, prospective study was conducted in Department of Surgery at SCL Hospital, Saraspur, Ahmadabad, Gujarat, India, from August 2017 to July 2018. The study included 80 patients between the age group of 20 and 70 years, diagnosed to have grade III or IV haemorrhoids. The patients were divided into two groups. Group OH included patients undergoing open haemorrhoidectomy (n=40) and Group SH included patients undergoing stapled haemorrhoidectomy (40 patients). Postoperatively, 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 was done based on Student’s t-test. Results: Out of the total 80 patients, 36(90%) were males and 4(10%) females in OH group whereas 35(87.5%) were males and 5(12.5%) females in SH group. The mean age of patients in the OH group was 42.2 years, while for SH the mean age was 38.5 years. In both groups, postoperative anal incontinence was not seen. Based on independent Student’s t-test, the postoperative pain (p-value=0.024), postoperative hospital stay (p-value=0.032) and duration of resumption of daily activity (p-value=0.003) parameters found to be significantly lesser in SH group as compared to OH group. However, complications observed were comparable in both the groups like postoperative bleeding, urinary retention, and anal incontinence. Conclusion: Stapled Haemorrhoidopexy is safe procedure with number of advantages in terms of short operative time and less post op complications. However, as far as recurrence rate assessment in SH technique is concerned, long term follow-ups are required.