Which is better: stapler haemorrhoidopexy vs traditional excisional surgery?
DOI:
https://doi.org/10.18203/2349-2902.isj20192077Keywords:
Stapler, Hemmoroidectomy, HemmoroiodopexyAbstract
Background: Haemorrhoids are tortuous dilated veins within the submucosa of anal canal. They are external, internal or internoexternal. External haemorrhoids cause pain. Internal haemorrhoids are characterised by painless bleeding or prolapse. Various treatment options are available- dietary modification, band ligation, sclerosant therapy, cryosurgery, traditional excisional surgery (Milligan/Ferguson), stapler haemorrhoidopexy, Doppler guided haemorrhoidal artery ligation (DGHAL), application of harmonicscalpel and ligasure.
Methods: Adult patients (>18 yrs) with grade II, III & grade IV haemorrhoids are randomly allotted in equal numbers to receive either stapler haemorrhoidopexy or traditional excisional surgery from July 2017 to December 2018. Post-operative complications, pain (using visual analogue scale), recurrence rate and the need for further surgery with these procedures were analysed in this 1 and half year study period.
Results: Patients who underwent stapler haemorrhoidopexy had better temporary quality of life, but patients who underwent traditional excisional surgery had lesser recurrence.
Conclusions: Overall, traditional excisional surgery should be the choice when compared to stapler haemorrhoidopexy.
Metrics
References
Goligher JC. In Surgery of the Anus, Rectum and Colon. Haemorrhoids or piles. 5th Ed. Bailliere Tindall London 1992: 98-149.
Hawley PR. Haemorrhoids. In Rec AdvSurg no.8 Ed. Taylor S, Editor. London: Churchill Livingstone; 1973: 235-256.
Eastman PF, Applebaum IA. Critical evaluation of internal haemorrhoidal ligation as an outpatient procedure. Amer J Proctol. 1969;20:201-9.
Turell R. In Diseases of the colon and anorectum Ed. R Turell. Philadelphia, London: Saunders 1960: 888.
Iyer VS, Shrier I, Gordon PH: Long-term outcome of rubber band ligation for symptomatic primary and recurrent internal haemorrhoids. Dis Colon Rectum. 2004;47:1364-70.
Goligher JC. Surgery of the anus, rectum and colon. 5th edn. London: Bailliere Tindall; 1984: 993-996.
SeowChoen F. Stapled haemorrhoidectomy: pain or gain. Br J Surg. 2001;88:1-3.
Longo A. Treatment of haemorrhoids disease by reduction of mucosa and haemorrhoid prolapsed with circular suturing device: a new procedure. Proceedings of the 6th World Congress of Endoscopic Surg. 1998: 777-784.
Chen CW, Lai CW, Chang YJ, Chen CM, Hsiao KH. Results of 666 consecutive patients treated with LigaSure haemorrhoidectomy for symptomatic prolapsed haemorrhoids with a minimum follow-up of 2 years. Surgery. 2013;153:211-8.