Javed Iqbal, Muhammad Armoghan, Alia Amin.
Comparison of short term outcome of stapled hemorrhoidectomy with excisional Hemorrhoidectomy.
Pak J Surg Jan ;22(4):191-4.

Objective: To compare the short term outcome of stapled haemorrhoidectomy with excisional haemorrhoidectomy. Design & Duration: Prospective comparative study from June 2005 to April 2006. Setting: Department of Surgery (Unit IV), Bahawal Victoria Hospital, Bahawalpur. Patients: The study included 37 patients of 3rd to 4th degree prolapsed haemorrhoids. Methodology: The data of all the patients was collected. Seventeen out of them underwent stapled haemorrhoidec- tomy (Group-I) while 20 underwent excisional haemorrhoidectomy (Group-II). Short term outcome of both groups were compared. The comparison criteria was operative time, hospital stay, post-operative pain, post-operative bleeding requiring intervention, patient?s satisfaction and total cost in rupees. Results: Both the groups were comparable as far as age and gender distribution, and the stage of the disease was concerned. The operative time in Group-I was 35 minutes and in Group-II 65 minutes (p<0.001). Mean hospital stay was lower in Group-I as compared to Group-II (1.09 vs 2.82 nights, p<0.001). Objective assessment of pain showed less post-operative pain in patients with stapled haemorrhoidectomy (p 0.04). No patient of Group-I, but 15% of Group-II bled post-operatively. Ninety one percent patients with stapled haemorrhoidectomy were satisfied with the procedure whereas only 70% showed their satisfaction in Group-II. The cost of stapled haemorroidectomy was six times more than excisional haemorrhoidectomy. Conclusion: Stapling haemorrhoidectomy is a safe procedure for prolapsed haemorrhoids. It has definite short term advantages over excisional haemorrhoidectomy with reference to post-operative pain and early recovery. Patients` acceptance and satisfaction are high. However, it is more costly and this factor is important in our circumstances.

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