STAPLED HEMORRHOIDOPEXY A BETTER AND SAFER ALTERNATIVE TO OPEN HEMORRHOIDECTOMY IN THE MANAGEMENT OF GRADE III & IV HEMORRHOIDS- A HOSPITAL BASED STUDY

Abstract

Background: Surgical hemorrhoidectomy is usual method for management in hemorrhoid grade III and IV. It is generally associated with postoperative pain, long hospital stay and a longer convalescence. Stapled hemorrhoidopexy is a newer minimally invasive alternative for the treatment of hemorrhoids. Aims: In this study, the above two methods were compared with respect to short term outcomes. Settings and Design: This was a prospective and randomized study. Methods: 60 patients having grade 3 or 4 hemorrhoids and who fullled the criteria were included in the study. Thirty patients underwent stapled hemorrhoidopexy and other thirty underwent open hemorrhoidectomy. All patients were reviewed immediately after surgery and at 1, 3 and6 weeks post-operatively. The two groups were compared in terms of duration of surgery, hospital stay, return to work and post-operative level of satisfaction . Statistical Analysis: The statistical analysis was done using SPSS (Statistical Package for Social Sciences) Version 15.0 statistical Analysis Software. Signicance was assessed at 5% level of signicance. Student t-test was used to nd the signicance of study parameters on continuous scale in parametric condition between two groups (inter group analysis) and Mann Whitney U test was used to nd the signicance of study parameters on continuous scale in non-parametric condition within each group. Chi-square/ Fisher Exact test were used to nd the signicance of study parameters on categorical scale between two groups. Results: The overall mean age of patients in our study was 41.35 ± 12.80. The majority of patients in the study were males (78.3%) and had grade 3 haemorrhoids (93.3%). Stapled hemorrhoidopexy group had shorter duration of surgery, less postoperative pain and need for analgesia, shorter duration of hospital stay and earlier return to work and a high patient satisfaction as compared with open hemorrhoidectomy group. Conclusions: Stapled hemorrhoidopexy is a minimally invasive, better and safer alternative to open hemorrhoidectomy with many short-term benets.