Yousaf Jan, Waqas, Ahmad Din.
Effectiveness of closed haemorroidectomy in third degree haemorroids.
Pak J Surg Jan ;29(3):174-8.

Introduction: Haemorroids are engorged vascular cushions found within the submucosa of the anal canal. Th ey consist of a sacculated venous plexus with a rich arterial supply supported by a fi bromuscular connective tissue. Th e exact prevalence is unknown as many peoples do not seek medical att ention; however, it may be somewhere in the region of 4-36% depending on population. Th e incidence is higher in Western populations and is low in sub-Saharan Africa. Th ey normally contribute to the anal continence and protection of the sphincter mechanism during defecation and are found at constant positions within the anal canal (3, 7 0and 11 o clock positions). Objectives: Th e objective of my study is to determine the effi cacy of closed haemorroidectomy in the treatment of third degree haemorrhoids in terms of prolapse recurrence. Material and Methods: Th is study was conducted in General surgery ward Hayatabad Medical Complex Pesahwar. Th rough a Descriptive case series study design, 117 patients were included in the study between March to September 2011. All patients underwent closed haemorroidectomy by the same surgeon having more than fi ve years experience. Both males and females were included in the study. Follow up was done one month aft er the surgery and the data were collected using a specially designed proforma. Results: Th ere were 117 patients with third degree haemorroids who underwent closed haemorroidectomy and were observed for prolapse recurrence,in which 81(69.23%)were males and 36(30.76%) were females patients. Th e age of the patients ranges from 18 to 65 years and the average age was 36.08 years ± 8.88 SD. Total of 8(6.8%) recurrence were observed during the one month follow up. Out of 81(69.23) % male patients only 6(5.12) % have prolapse recurrence, and out of 36(30.76) % female patients only 2(1.70) % have prolapse recurrence. Conclusion: In conclusion, closed haemorroidectomy is cost eff ective and a more comfortable procedure with faster wound healing, less postoperative pain, bleeding and low recurrence rate as compared to most of the other surgical procedures for treatment of third degree haemorrhoids.

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