MANAGEMENT OF HAEMORRHOIDS BY OPEN AND CLOSED HAEMORRHOIDECTOMY– A COMPARATIVE STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 92
Abstract
BACKGROUND Haemorrhoids are estimated to affect nearly 40% of the population during their lifetime in some form or the other. Milder forms respond to conservative management whereas surgical approach is necessary in the others. Different surgical methods have their pros and cons, and therefore the method opted should be individualised. Aim- To compare the outcome of open and closed haemorrhoidectomy in second, third and fourth degree haemorrhoids. MATERIALS AND METHODS This prospective, comparative clinical trial was conducted in the Department of General Surgery, Silchar Medical College and Hospital from August 2016 to July 2017. 30 patients with 2nd, 3rd and 4th degree haemorrhoids were grouped into two groups, namely Group A (16 cases) who underwent open haemorrhoidectomy and Group B (14 cases) who underwent closed haemorrhoidectomy. Post-operatively the cases were followed up at 7th day, 4th week, 6th week, 3rd month and 6th month. RESULTS The mean age of the patients was 39.6 ± 4.8 years, 76.6% were males. 56.6% were symptomatic for more than two years; bleeding per anus being predominant. The mean duration of surgery and post-operative analgesic requirement was significantly lesser in Group A. Earlier return of bowel function was observed in Group A. However, post-operative evacuation of bowel was smoother and blood stain was lesser in Group B. Urinary retention during the first 24 hours and hospital stay in Group A was higher but insignificant. In the fourth week, significantly higher incidence of wound infection and serous discharge was observed in Group B, whereas pruritus and hypertrophied granulation tissue formation was significantly higher in Group A. In the sixth week, Group B showed greater incidence of wound healing and Group A showed greater incidence of pruritus and hypertrophied granulation tissue. Healing was completed in all the cases in both the groups in the third month. In the sixth month, skin tags were significantly higher in Group A. CONCLUSION Closed haemorrhoidectomy is better than open haemorrhoidectomy in terms of faster wound healing, smoother bowel clearance and cosmesis, but the operating time, analgesic requirement and infection rates are higher
Authors and Affiliations
Bikash Sandalya
Keywords
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- EP ID EP279185
- DOI 10.14260/jemds/2017/1417
- Views 107
- Downloads 0
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