Recent trends in management of haemorrhoids

Abstract

Background: Haemorrhoids are common clinical conditions. Their treatment is one of the most challenging situations in the field of general surgery. In this study, we compared and evaluated the results and postoperative complications of Lords dilatation procedure and haemorrhoidectomy.Methods: The study evaluates comparative results of Lords dilatation procedure and haemorrhoidectomy. This study was conducted over a period of 1 year from January 1984 to December 1984. It includes 40 patients with haemorrhoids who attended surgical OPD of Krishnarajendra Hospital, Mysore. These 40 patients were selected randomly and divided into two groups of 20 patients each (Lords dilatation group and haemorrhoidectomy group). All parameters including clinical, physical and baseline investigations for all patients were recorded and finally analysed.Results: The age of the patients ranged from 20-70 years. Male preponderance was observed (7:1). The commonest symptoms were mass per rectum (90% and 85%) and bleeding P/R (85%), pain during defecation (85% and 70%) in Lords dilatation and haemorrhoidectomy groups respectively. Protoscopic examination revealed the presence of grade II haemorrhoids in most of the patients in both the groups, 45% and 65% respectively. Postoperative complications including pain, sphincter incontinence, bleeding and urinary retention is high in haemorrhoidectomy group as compared to Lords dilatation group. Recurrence of haemorrhoids (5%) and fecal incontinence (5%) was observed in Lords dilatation group after 6 months of treatment.Conclusions: Haemorrhoidectomy for treatment of hemorrhoids offers the best immediate and long term results compared to Lords dilatation.