Asad Mehmood Malik, Muhammad Rafiq Zafar, Shafqat Ali Abbasi.
Submucosal closed and open (Ligation Excision) Haemorrhoidectomy (A Comparison of two methods).
Pak Armed Forces Med J Jan ;47(2):4-7.

Submucosal closed (SMC) and open i.e., ligation excision (LE) haemorrhoidectomy were objectively compared for results and postoperative complications of these two procedures. 88 patients were randomly assigned to either SMC (n=44) or LE In=44) haemorrhoidectomy, irrespective of the age and sex. Patients were evaluated by means of digital rectal examination, proctoscopy and symptom grading preoperatively, one month and then one year after the surgery. Any complication observed during postoperative period was noted. Postoperative pain was assessed by linear analogue scale and the amount of analgesics required postoperatively. SMC haemorrhoidectomy was found to be more time consuming 150 minutes as compared to 30 minutes for LE haemorrhoidectomy). However, the severity of the postoperative pain was much less (mean pain score 2.5) in this procedure as compared to open haemorrhoidectomy (mean pain score 4.01. Wound healing was rapid (1-2 weeks) in SMC haemorrhoidectomy as compared to 6-8 weeks in open haemorrhoidectomy and there was significantly lower incidence of postoperative urinary retention and reactionary haemorrhage in SMC haemorrhoidectomy when compared with LE haemorrhoidectomy. We conclude that SMC haemorrhoidectomy, although technically difficult and more time consuming, is better procedure than LE haemorrhoidectomy (open haemorrhoidectomy).

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com