Stapled hemorrhoidopexy versus open hemorrhoidectomy: a comparative study of short term results

Authors

  • Idoor D. Sachin Department of General Surgery, Pushpagiri Institute of Medical Sciences and Research Centre, Tiruvalla, Kerala, India
  • Om Prakash Muruganathan Department of General Surgery, Pushpagiri Institute of Medical Sciences and Research Centre, Tiruvalla, Kerala, India

DOI:

https://doi.org/10.18203/2349-2902.isj20164791

Keywords:

Hemorrhoids, Milligan morgan hemorrhoidectomy, Stapled hemorrhoidopexy

Abstract

Background: Hemorrhoids are usually managed by surgical hemorrhoidectomy which is associated with postoperative pain, long hospital stay and a longer convalescence. Stapled hemorrhoidopexy is a newer alternative for the treatment of hemorrhoids. In this study, the two methods were compared for short term outcomes.

Methods: Hundred patients having grade 3 or 4 hemorrhoids and who fulfilled the criteria were included in the study from June 2012 to May 2014. Fifty patients underwent stapled hemorrhoidopexy and other fifty underwent open hemorrhoidectomy. All patients were reviewed immediately after surgery and at 1, 3, 6 weeks and 6 months post-operatively. The two groups were compared for duration of surgery, hospital stay, return to work and post-operative complications.

Results: The mean (S.D.) age was 40.06 (10.33) in our study. The majority of patients in the study were males and had grade 4 haemorrhoids. Stapled hemorrhoidopexy group had shorter duration of surgery, less postoperative pain and need for analgesia, shorter duration of hospital stay and earlier return to work and a high patient satisfaction as compared with open hemorrhoidectomy group. There were no major post-operative complications, recurrence, residual prolapse or incontinence in the follow up period of six months in the stapled group.

Conclusions: Stapled hemorrhoidopexy is a safer alternative to open hemorrhoidectomy with many short-term benefits.

References

Sayfan J, Becker A, Koltun L. Sutureless closed hemorrhoidectomy: a new technique. Ann Surg. 2001;234(1):21-4.

Shalaby R, Desoky A. Randomized clinical trial of stapled versus Milligan - Morgan haemorrhoidectomy. Br J Surg. 2001;88(8):1049-53.

Milligan ETC, Morgan CN, Jones LE, Officer R. Surgical anatomy of the anal canal and the operative treatment of hemorrhoids. Lancet. 1937;2:119-24.

Mehigan BJ, Monson JR, Hartley JE. Stapling procedure for haemorrhoids versus Milligan-Morgan haemorrhoidectomy: randomised controlled trial. Lancet. 2000;355(9206):782-5.

Rowsell M, Bello M, Hemingway DM. Circumferential mucosectomy (stapled haemorrhoidectomy) versus conventional haemorrhoidectomy: randomised controlled trial. Lancet. 2000;355(9206):779-81.

Ganio E, Altomare DF, Gabrielli F, Milito G, Canuti S. Prospective randomized multicentre trial comparing stapled with open haemorrhoidectomy. Br J Surg. 2001;88(5):669-74.

Fazio VW. Early promise of stapling technique for haemorrhoidectomy. Lancet. 2000;355(9206):768-9.

Rovelo JM, Tellez O, Obregon L. Stapled rectal mucosectomy vs. closed hemorrhoidectomy: a randomized clinical trial. Dis Colon Rectum. 2002;45:1367-75.

Hetzer FH, Demartines N, Handschin AE. Stapled vs. excisional hemorrhoidectomy: long-term results of a prospective randomized trial. Arch Surg. 2002;137:337-4.

Singer MA, Cintron JR, Fleshman JW. Early experience with stapled hemorrhoidectomy in the United States. Dis Colon Rectum. 2002;45:360-9.

Khan NF, Hussain Shah SS, Bokhari I. Outcome of stapled haemorrhoidectomy versus Milligan Morgan's haemorrhoidectomy. J Coll Physicians Surg Pak. 2009;19(9):561-5.

Tjandra JJ, Chan MK. Systematic review on the procedure for prolapse and hemorrhoids (stapled hemorrhoidopexy. Dis Colon Rectum. 2007;50(6):878-92.

Stolfi VM, Sileri P, Micossi C, Carbonaro I, Venza M, Gentileschi P, et al. Treatment of hemorrhoids in day surgery: stapled hemorrhoidopexy vs Milligan-Morgan hemorrhoidectomy. J Gastrointest Surg. 2008;12(5):795-801.

Khalil KH, Bichere A, Sellu D. Randomized clinical trial of sutured versus stapled closed haemorrhoidectomy. Br J Surg. 2000;87:1352-5.

Bikhchandani J, Agarwal PN, Kant R. Randomized controlled trial to compare the early and mid-term results of stapled versus open hemorrhoidectomy. Am J Surg. 2005;189(1):56-60.

Ng KH, Ho KS, Ooi BS. Experience of 3711 stapled haemorrhoidectomy operations. Br J Surg. 2006;93:226-30.

Jayaraman S, Colquhoun PH, Malthaner RA. Stapled versus conventional surgery for haemorrhoids. Cochrane Database Syst Rev. 2006;4:CD005393.

Laughlan K, Jayne DG, Jackson D, Rupprecht F, Ribaric G. Stapled haemorrhoidopexy compared to Milligan- Morgan and Ferguson haemorrhoidectomy: a systematic review. Int J Colorectal Dis. 2009;24(3):335-44.

Cheetham MJ, Mortensen NJM, Nystom PO, Kamm MA, Phillips RKS. Persistent pain and faecal urgency after stapled haemorrhoidectomy. Lancet. 2000;356:730-3.

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Published

2017-01-25

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Original Research Articles