DOI: http://dx.doi.org/10.18203/2349-2902.isj20191259

Stapled haemorrhoidopexy vs. open haemorrhoidectomy: a comparative study

Naman Aggarwal, Saurabh Agrawal, Jitendra P. Ray

Abstract


Background: Haemorrhoidal disease is one of the most common anorectal disorders. The grading of haemorrhoids depend on their severity and tendency to prolapse. Surgery is essential for grade 3 and 4 haemorrhoids. This study aims to compare the outcomes of the stapled haemorrhoidopexy and open haemorrhoidectomy in terms of intra and postoperative complications in terms of pain, return to activity of daily living (ADL) i.e. return to functional activity.

Methods: A single-centred observational follow-up study on patients undergoing surgery for haemorrhoids between 2016-2017. Total number of patients operated were 106. Total cases included in the study are 95, out of which 59 were in open haemorrhoidectomy group and 36 in stapled haemorrhoidopexy group. Data was collected and the various parameters compared between the two groups.

Results: The most common symptom found in the study was bleeding per rectum (91%). Intraoperative bleeding was more in open group compared to the stapled group (p<0.005). The pain experienced in the immediate postoperative period was higher for the open group (p<0.005). Noticeable difference in the hospital stay between the two groups was observed, with stapled group being discharged earlier (p<0.005). The immediate postoperative complications were not significantly different in the two groups. The need for postoperative analgesia was seen to be lesser in the stapled group compared to the open group (p<0.005).

Conclusions: Our study confirms that stapled haemorrhoidopexy is better than open haemorrhoidectomy in terms of intra operative duration and pain experienced by the patient with an early return to activities of daily living.


Keywords


Haemorrhoids, Open haemorrhoidectomy, Stapled haemorrhoidopexy

Full Text:

PDF

References


Jayaraman S, Colquhoun PH, Malthaner RA. Stapled haemorrhoidopexy is associated with a higher long term recurrence rate of internal hemorrhoids compared with conventional excisional hemorrhoid surgery. Dis Colon Rectum. 2007;50(9):1297-305.

Ganio E, Altomare DF, Milito G, Gabrielli F, Canuti S. Prospective randomized multicentre trial comparing stapled with open hemorrhoidectomy. Br J Surg. 2001;88;669-74.

Sutherland LM, Burechard AK, Matsuda K, Sweeney JL, Bokey EL, Childs PA, et al. A systematic review of stapled hemorrhoidectomy. Arch Surg. 2002;137:1396–407.

Ganio E, Altomare DF, Milito G, Gabrielli F, Canuti S. Long term outcomes of a multicentric randomized trial of stapled haemorrhoidopexy versus Milligan-morgan haemorrhoidectomy. Br J Surg. 2007;94:1033-7.

Mattana C, Caco C, Manno A, Verbo A, Rizzo G, Petito L, et al. Stapled hemorrhoidopexy and Milligan Morgan Hemorrhoidectomy in the cure of fourth degree hemorrhoids: Long term evaluation and clinical results. Dis Colon Rectum. 2007;50:1770-5.

Cheetham MJ, Cohen CRG, Kamm MA, Philips RKS. A randomized controlled trail of diathermy hemorrhoidectomy versus stapled hemorrhoidec-tomy in an intended day care setting with longer follow up. Dis Colon Rectum. 2002:46;491–7.

Gravié JF, Lehur PA, Huten N, Papillon M, Fantoli M, Descottes B, Pessaux P, Arnaud JP. Stapled hemorrhoidopexy versus milligan-morgan hemorrhoidectomy: a prospective, randomized, multicenter trial with 2-year postoperative follow up. Annals Surg. 2005;242(1):29.

Pavlidis T, Papaziogas B, Souparis A, Patsas A, Koutelidakis I, Papaziogas T. Modern stapled Longo procedure vs. conventional Milligan-Morgan hemorrhoidectomy: a randomized controlled trial. International J Colorectal Dis. 2002;17(1):50-3.

Singer M, Cinton J. New techniques in the treatment common perianal diseases; Stapled haemorrhoidopexy, Botulinum toxin and Fibrin sealant. Surgical Clin N Am. 2006;86:937–67.

John C, Joel A, Frederick A. Inflammatory polyps: A cause of late bleeding in stapled hemorrhoidec-tomy. Dis Colon Rectum. 2006:49;1910–3.

Ortiz H, Marzo J, Armendariz P. Randomized clinical trial of stapled haemorrhoidopexy versus conventional diathermy hemorrhoidectomy. Br J Surg. 2002;89:1376–81.

Brusciano L, Ayabaca SM, Pescatori M. Reinterventions after complicated or failed stapled hemorrhoidopexy. Dis Colon Rectum. 2002:47;1846–51.

Kairraluaoma M, Nuorva K, Kellokunpu. Day case stapled versus Diathermy hemorrhoidectomy – A randomized control trial evaluating surgical and functional outcomes. Dis Colon Rectum. 2003;46:93–9.

Senagore AJ. Singer M. Ebcarian H. A prospective randomized control multicentric study comparing stapler hemorrhoidopexy and Ferguson hemorrhoidectomy – Perioperative and 1 year results. Dis Col Rectum. 2004;47;1824-36.