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Open hemorrhoidectomy versus stapler hemorrhoidopexy: A prospective study

Abstract

Mumtaz Din Wani, Shabir Ahmad Mir, Saleem Javaid, Yawar Watali

Background: Stapled hemorrhoidectomy, though significantly less painful, is still in its evolutionary stages, especially in the developing world. The present study was undertaken to ascertain the efficacy, safety and advantages, if any, of the stapled hemorrhoidopexy. Material and Methods: This prospective study comprised of patients admitted for elective surgery of hemorrhoids over a period of 18 months during the period of January 2014 to June 2015 in various surgical wards of SMHS (Shri Maharaja Hari Singh) Hospital, Srinagar. The patients were randomized into two groups. One group underwent conventional open hemorrhoidectomy and the other group, stapled hemorrhoidopexy. Results: In our study, the mean operating time for stapled hemorrhoidopexy was 35.22±7.23 minutes with an average of 20-50 minutes, while with open hemorrhoidectomy, the mean operating time was 45.67±11.94 minutes (p<0.001). The mean VAS scores at 6, 12 and 24 hours with stapled hemorrhoidopexy were 1.78±0.77; 1.82±0.61 and 1.42±0.62, respectively, and with open hemorrhoidectomy, the mean VAS scores at 6, 12 and 24 hours were 2.89±0.86; 2.13±0.82 and 1.89±0.80, respectively. The mean hospital stay for patients with stapled hemorrhoidopexy was 1.96±0.55 days in comparison to the open group where the mean hospital stay was 3.51±0.72 days (P-value<0.001). The mean amount of blood loss during stapled hemorrhoidectomy was statistically less than in open surgery; the mean hospital stay in patients with stapled hemorrhoidopexy was 1.96±0.55 days versus the open group, where the mean hospital stay was 3.51±0.72 days (p <0.001). Conclusion: The use of a circular stapler in the treatment of hemorrhoids is safe, effective, causes minimal pain and is associated with fewer complications than conventional hemorrhoidectomy