Comparison of Conventional ( CH ) Vs Stapled Haemorrhoidectomy ( SH ) ; Three Years ’ Experience

Background: Haemorrhoids are one of the most common anorectal disorders. Haemorrhoids surgical techniques are classified as Open, Closed and Stapled ones. Radical surgery is the only therapeutic option in case of III and IV stage haemorrhoids The Milligan-Morgan open haemorrhoidectomy is the most widely practiced surgical technique used for the management of haemorrhoids and is considered the current "gold standard". In 1995, Longo described a new and innovative operative technique for haemorrhoid. The procedure of MIPH is performed in the patient with piles on distal rectal mucosa and sub mucosa, proximally to the dentate line. MIPH haemorrhoidectomy includes excision of a band of excessive or loose prolapsed mucosa and sub mucosa within the rectum, proximally to the haemorrhoidal tissue and fixation of the mucosa by stapled end to end mucosa anastomosis. This minimally invasive maneuver occludes the blood supply of the superior haemorrhoidal artery above the haemorrhoidal tissue and thus piles are cured as well as prolapsed mucosa is retracted up. This study was conducted from June 2014 to May 2017 focusing on early, middle and late complications, indications and contraindications, satisfaction level of both surgical procedure for haemorrhoid and post operative pain score. Methods: One hundred and fifty patients were recruited from June 2014 to May 2017.Out of 150, 50 underwent surgery with traditional open or closed technique and 100 with the stapled Haemorrhoidectomy (SH) technique due to patients prefence.. Only patients with symptomatic haemorrhoids at III or IV stage were included retrospectively. Results: There were no differences between CH and SH about procedure time. Bleeding is the most commonly observed as early complication with a statistically significant difference in favour of SH. Pain relief was better in SH group compared to conventional one. We also observed that pain level influences the outcome after surgical treatment. No chronic pain cases were observed in both groups. There were no statistical significant differences between two groups about incontinence to flatus, urinary retention, faecal incontinence, substenosis and anal burning. No cases of anal stenosis were observed. Rectal prolapse and haemorrhoidal recurrence were observed as late complications, especially after SH. Conclusion: ?