COMPARISON OF OPEN AND CLOSED TECHNIQUES OF HAEMORRHOIDECTOMY IN TERMS OF POST-OPERATIVE COMPLICATIONS
Abstract
Background: Haemorrhoids have been diagnosed and treated since the dawn of civilization, yet their cause, nature, symptomatology and especially their treatment options, remain hotly debated. The general principle however is that treatment should be directed by symptoms and the degree of haemorrhoids. The objective of the study is to compare early and late complications and wound healing time in open versus closed methods of haemorrhoidectomy. Methods: This was a Randomized control trial conducted at Department of Surgery CMH Kharian for a period of 3 years. During the period of study, patients presenting in Surgical OPD (Age Range 20-72 Years) with 3rd or 4th degree haemorrhoids requiring haemorrhoidectomy (n=364) were divided in two groups:- Group-1 was subjected to haemorrhoidectomy by open (Milligan-Morgan) technique and Group-2 underwent closed (Ferguson) haemorrhoidectomy. All patients were followed up for 2 months post-operatively and assessed for duration of wound healing and post-operative complications. Results: In group-1 (Open haemorrhoidectomy) patients' ages ranged from 21-70 years with a mean age of 43 years (SD±12.51). Duration of wound healing in this group was on the average 22 days (SD±5.76). Incidence of early post-operative complications including haemorrhage, infection and urinary retention was 4.94%, 8.24% and 7.14% respectively. The only late complication observed was anal stenosis in one patient (0.55%). No fissure or faecal incontinence was observed in this group. In group-2 (subjected to closed haemorrhoidectomy), patients' ages ranged from 20-72 years with a mean age of 42 years (SD±10.31). Duration of wound healing was on the average 14 days (SD±3.25). Incidence of early post- operative complications, i.e., haemorrhage, infection and urinary retention was 2.19%, 7.69% and 2.75% respectively. No late complications (stenosis, fissure or incontinence) were observed in this group. Conclusion: There is no statistical significant difference between open and closed haemorrhoidectomy for the treatment of 3rd and 4th degree haemorrhoids in terms of wound healing time and post-operative complications.References
Thomson WH. Anus. In: Morris PJ, Malt RA editors. Oxford Textbook of surgery. New York: Oxford University Press 1994;1125-36.
William NS. The anus and anal canal. In: Russell RCG, William NS, Bulstrode CJK editors. Bailey. Love short practice of surgery.24th ed. London. Arnold 2004;1255-62.
Aroya A, Perez F, Miranda E, Serrano P, Candela F, Lacueva J, et al. open versus closed day case haemorrhoidectomy, is there any difference ? Results of a prospective randomized study. Int J Colorectal Dis 2004;19(4):370-3.
Ahmed A, Noor F, Hussain R, Chowdry Z, Qadir S. Strengths and limitations of close vs. open haemorrhoidectomy in patients of 2nd and 3rd degree haemorrhoids. Ann KE Med Coll 2003;9:219-20.
Malik GA, Wahab A, Ahmed I. Haemorrhoidectomy: Open Versus closed technique . J Surg Pak 2009;14(4):170-2.
Shoaib M, Ali AA, Naqvi N, Gondal KM, Chaudhry AM. Open versus closed haemorrhoidectomy, an experience at Mayo Hospital. Ann KE Med Coll 2003;9:65-8.
You SY, Kim SH, Chung CS, Lee DK. Open VS closed haemorrhoidectomy. Dis colon Rectum 2005;48(1):108-13.
Mik M, Rzetecki T, Sygut A, Trzcinski R, Dziki A. Open and closed haemorrhoidectomy for fourth degree haemorrhoids--comparative one center study. Acta Chir Iugosl 2008;55(3):119-25.
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