Stapler hemorrhoidectomy versus open hemorrhoidectomy

Abstract

Background:  Hemorrhoidal disease is a painful concern to the sufferer and the treating surgeon. Several methods are available for treatment of hemorrhoids. Milligan Morgan hemorrhoidectomy is the most widely p racticed Gold standard surgical technique for the management of 3 rd a nd 4 th degree hemorrhoids. Staplers are novel methods known for its s implicity, ease and standardization to an anastomosis. Methods: A pros pective randomized control study was done including 60 consecutive pat ients.  The patients were divided into two groups viz. Stapler hemorrh oidectomy group (SH) and Open (Milligan Morgan) hemorrhoidectomy group (OH). Randomization of the patient and assigning them to either of th e group was done by the sealed envelope technique on the morning of th e surgery. Pain score data sheet was filled out by the patients postop eratively. Data was analysed using SPSS. Significant difference was es timated using Chi Square test and Student’s ‘t’ independent test.  Lev el of significance was taken as 0.05. Results:  Sixty patients in two equal groups were studied.  Mean age of the two groups was similar.  T he male: female ratio was 6.5:1 for the stapled group and 9:1 for the open group.  The mean operating time for open group was significantly higher than the stapled group (P = 0.0001).  The SH group returned to normal activity significantly early. There was no significant differen ce in pain score on day one.  Pain score was significantly lower for t he SH group on days 2 and 3. There was no significant difference in co mplication between the two groups. Conclusions:  Operative time, durat ion of hospital stay and return to normal activity were satisfactory w ith stapler hemorrhoidectomy than the open method. Hence those who can afford the cost of surgery will definitely benefit, though it cannot be prescribed to all patients due to economic constraints. We still su ggest long-term follow-up of all stapler hemorrhoidectomy patients.