Plication: an innovative method of treating piles

Abstract

Background: The cause of haemorrhoids remains unknown. Factors contributing to haemorrhoids are constipation, prolonged squatting, pregnancy, aging, heredity, portal hypertension, abdominal tumour etc.Methods: This prospective study was carried out in department of surgery, M.K.C.G MCH, Berhampur, Odisha, India from 01st August 1995 to 31st July 2017. Patients from both sex and different age groups having haemorrhoids were included. Patients with piles secondary to anorectal tumours, prolapsed and thrombosed piles, anorectal pathology like fissure were excluded from study. Preoperative, intraoperative interventions and postoperative care were carried out according to laid procedure described below.Results: Total 1014 patients of piles were selected for plication and conventional haemorrhoidectomy and most of them were between 31-50 years of age while 362 cases underwent plication, rest 346 cases were treated with haemorrhoidectomy. All patients in this study had bleeding per rectum as the main symptom. Out of 507 patients which has been examined for plication, 272 (53.65%) had 2nd degree, 235 (46.35%) had 3rd degree piles. Results of plication of piles are satisfactory and only 4% patients had pain for which long term analgesics were given.Conclusions: Treatment of haemorrhoids is well debated topic and various methods are being used by surgeons all over world. Plication of piles appears to have significant advantages over conventional methods in terms of patient comfort, duration of stay in hospital and incidence of complications. Literature on this subject is briefly reviewed.

Study on Efficacy of Plication of Haemorrhoids

“…[12,16,14] Pattanayak S et al observed intra and postoperative bleeding occurred in (1.37%) in contrast to conventional method in which (13.4%) cases were having bleeding. [18] Agrawal S. et al, observed no postoperative bleeding. [17] Postoperative Retention of Urine Single case of postoperative retention of urine was noted in our series 80y /m who was also suffering from fistula in ano and bph.…”

“…[17] Pattanayak S. et al observed in his study 484 patients (95.47%) got relieved from postoperative pain by 72 hours, whereas in conventional method only 178 patients (35.10%) got relief from postoperative pain by 72 hours. [18] Intra-Operative and Postoperative Bleeding…”

“…[13] Pattanayak S et al observed 82.06% of patients had painless bowel movements , 13.01% patients had painful bowel movements with blood in stool, 4.93% patients had painful bowel movements without blood in stool after plication method whereas only 3.16% of patients had painless bowel movements, 28.40% patients had painful bowel movements with blood in stool, 68.44% patients had painful bowel movements without blood in stool after conventional method. [18] Early Recovery…”

“…[16] Pattanayak S et al observed reported all the patients who underwent plication stayed in the hospital for 1-2 days, and were able to carry out their daily work after 5-7 days but in conventional method in his study the patient had to stay in the hospital for 5-9 days, and were able to carry out their daily work after 14-26 days. [18] Follow up Our cases have been followed up for 6 months in the present study. The results were satisfactory.…”

“…[16] Pattanayak S et al observed 97.8% patients had no longterm complications, only 2.16% patients had long-term recurrent bleeding, no patients had incontinence to faeces/flatus, anal continence, recurrence after plication whereas after conventional method 75.8% patients had no long-term complications, 7.69% patients had recurrent bleeding, 6.90% had incontinence to faeces/flatus, 2.36% had anal stenosis, 7.29% had recurrence as long-term complications. [18]…”