A Comparative Study of Cases of Hemorrhoidectomy with Lateral Sphincterotomy and Hemorrhoidectomy without Lateral Sphincterotomy in Tertiary Care Centre
Journal Title: New Indian Journal of Surgery - Year 2018, Vol 9, Issue 5
Abstract
Introduction: Hemorrhoids are most common human disease defined as downward vascular displacement of submucosal cushions of the anal canal. In the past, various methods of treatment were presented for asymptomatic patients, however the surgical management has remained the best option available throughout. The commonest complication of open hemorrhoidectomy is post operative pain due to spasm of the internal sphincter which is also the cause of post operative urine retention, thus commonly performed procedure for relieving spasm and pain is lateral sphincterotomy. Lateral sphincterotomy adopted as a method to relieve sphincter spasm was thought to cause fecal incontinence as sphincter fibres are cut causing loss of anal tone. Hence a trial was made to evaluate whether combination of lateral sphincterotomy along with hemorrhoidectomy can help in the post-operative pain relief and reduce incidences of post operative urine retention and to know if lateral sphincterotomy is associated with fecal incontinence. The study aim was to evaluate the advantages of hemorrhoidectomy with lateral sphinctreotomy over hemorrhoidectomy done alone and association of fecal incontinence as a complication of lateral sphincterotomy. Material and Methods: This prospective study was conducted at Great Eastern Medical School, Srikakulam, and Andhra Pradesh, India between JULYS 2015 and JULY 2017 after obtaining an ethical clearance on consenting 100 patients who chose conventional open hemorrhoidectomy. Using lottery methods the patients were divided into two groups. Group A included patients with conventional open hemorrhoidectomy and lateral sphincterotomy. In Group B only open hemorrhoidectomy was done. Using Visual Analog Scale pain assessment was done on day - 0, 1, 2, and 7 respectively. Based on symptoms urine retention was assessed according to need for catheterization, fecal incontinene. Results: We found statistically that there was significant pain relief in the group to whom lateral sphincterotomy was added, lesser incidences of urine retention no cases of fecal incontinence were reported. Conclusion: In this study we conclude that the convenient and effortless way to reduce the postoperative pain with lesser urinary retention chances without risk of fecal incontinence is with conventional open hemorrhoidectomy along with lateral sphincterotomy which ensure better post operative period.
Authors and Affiliations
B. Mallayya .
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- EP ID EP548492
- DOI 10.21088/nijs.0976.4747.9518.9
- Views 95
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