Conventional HemorrhoidectomyVersus Stapled Hemorrhoidopexy: Compare the Outcomes of Both Techniques in Patients With Grade III and IV Hemorrhoids
Zardad Khan, Sajid Razzaq, Nasir Zareen, Atif Hussain, Muhammad Kashif, Javed Iqbal Khan
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ABSTRACT
Aim: To examine the outcomes of stapled hemorrhoidopexy and
compare with conventional open hemorrhoidectomy in patients presented with
grade III and IV hemorrhoids.
Study design: Randomized controlled trial
Place and duration: Department of surgery, Divisional
Headquarter Teaching Hospital Mirpur AJK/CMH Rawalakot during from 31-05-2018
to 31-05-2019.
Methods: Total 244 patients of both genders with ages
20 to 65 years presented with grade III and IV hemorrhoidal disease. All the
patients were equally divided into two groups. Group I consist of 122 patients
and received conventional hemorrhoidectomy, group II with same number of
patients received stapled hemorrhoidopexy. Outcomes such as bleeding,
postoperative pain by (VAS), hospital stay, return to normal activities and
recurrence. Primary outcome was recurrence of hemorrhoids and examined at 6, 12
and 18 months postoperatively. Data was analyzed by SPSS 24.0.P-value <0.05
was taken as statistically significant.
Results: There were 102 (83.61%) males and 20(16.39%)
females in group I and in group II 105 (86.07%) were males and 17(13.93%) were
females. No significant difference regarding age and body mass index was
observed between both groups (p-value >0.05). Shorter hospital stay, less
bleeding and less post-operative pain and shorter duration of surgery is
associated with stapled hemorrhoidopexy with p-value <0.05. Recurrence rate
was high in patients with stapled hemorrhoidopexy group as compared to
conventional hemorrhoidectomy at final follow-up (p-value <0.001).
Conclusion: Stapled hemorrhoidopexy is safe and effective
with less complications as compared to conventional hemorrhoidectomy. However,
high recurrence is associated with stapled hemorrhoidopexy.
Keywords: Hemorrhoids, Stapled Hemorrhoidopexy,
Conventional Hemorrhoidectomy, Hospital stay,
ABSTRACT
Aim: To examine the outcomes of stapled hemorrhoidopexy and
compare with conventional open hemorrhoidectomy in patients presented with
grade III and IV hemorrhoids.
Study design: Randomized controlled trial
Place and duration: Department of surgery, Divisional
Headquarter Teaching Hospital Mirpur AJK/CMH Rawalakot during from 31-05-2018
to 31-05-2019.
Methods: Total 244 patients of both genders with ages
20 to 65 years presented with grade III and IV hemorrhoidal disease. All the
patients were equally divided into two groups. Group I consist of 122 patients
and received conventional hemorrhoidectomy, group II with same number of
patients received stapled hemorrhoidopexy. Outcomes such as bleeding,
postoperative pain by (VAS), hospital stay, return to normal activities and
recurrence. Primary outcome was recurrence of hemorrhoids and examined at 6, 12
and 18 months postoperatively. Data was analyzed by SPSS 24.0.P-value <0.05
was taken as statistically significant.
Results: There were 102 (83.61%) males and 20(16.39%)
females in group I and in group II 105 (86.07%) were males and 17(13.93%) were
females. No significant difference regarding age and body mass index was
observed between both groups (p-value >0.05). Shorter hospital stay, less
bleeding and less post-operative pain and shorter duration of surgery is
associated with stapled hemorrhoidopexy with p-value <0.05. Recurrence rate
was high in patients with stapled hemorrhoidopexy group as compared to
conventional hemorrhoidectomy at final follow-up (p-value <0.001).
Conclusion: Stapled hemorrhoidopexy is safe and effective
with less complications as compared to conventional hemorrhoidectomy. However,
high recurrence is associated with stapled hemorrhoidopexy.
Keywords: Hemorrhoids, Stapled Hemorrhoidopexy,
Conventional Hemorrhoidectomy, Hospital stay,