COMPARATIVE STUDY OF DIFFERENT TREATMENT MODALITIES OUTCOMES FOR HEMORRHOIDAL DISEASE

Davinder Kumar; Reena Kothari; Dilip Thakur; Uday Somasekhar; Ritu Bhukal; Dhanajay Sharma; Narottam Singh Argal

doi:10.33695/jss.v8i4.516

Davinder Kumar Netaji Subash Chandra Bose Medical College Jabalpur
Reena Kothari Department of Surgery, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India
Dilip Thakur Department of Surgery, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India
Uday Somasekhar Department of Surgery, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India
Ritu Bhukal Department of Pathology, Pandit Bhagwat Dayal Sharma, Post Graduate Institute of Medical Science, Rohtak, Haryana
Dhanajay Sharma Department of Surgery, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India
Narottam Singh Argal Department of Surgery Pandit Bhagwat Dayal Sharma, Post Graduate Institute of Medical Science, Rohtak, Haryana

DOI: https://doi.org/10.33695/jss.v8i4.516

Keywords: Open Haemorrhoidectomy, Closed Haemorrhoidectomy, Harmonic Scalpel Haemorroidectomy, Laser Haemorrhoidectomy, Stappler Haemorrhoidectomy

Abstract

The aim of this study is to compare the outcomes of different surgical modalities for mainly grade III and IV hemorrhoids in terms of operative time, postoperative pain, complications and duration of hospital stay. A prospective comparative study of outcomes of different modalities of treatment of hemorrhoids was done from October 2016 to 31^st August 2018 at department of general surgery N.S.C.B. Medical College and Hospital, Jabalpur. We operated 94 patients and divided them into four groups. A (open hemorrhoidectomy MM), B (stapler hemorrhoidectomy MIPH), C (Laser hemorrhoidectomy), D (Harmonic Scalpel hemorrhoidectomy). A follow up of patient was done for 3 months in each group. The majority of patients fall in the age group of 30 to 60 years with mean age of 42.39 years. Around 74.50% were males and 25.50% were females. The average operating time was for group A: 51.8 ±9.34, B: 41.37 ±6.09, C: 17.6±4.11, D:22.25±3.98. VAS pain scores postoperative day 1, week 1, week 4, week 12 were for Group A:5.64±1.25, 4.16±1.11,2.68 ±0.99, 1.16±0.8; Group B: 3.5±1.32, 2±0.83, 1.12±0.34, 0.12±0.34; Group C: 2.7±1.16, 0.92±1.0, 0,0; Group D: 3.9±0.97, 2.15±0.87, 0.51±0.5,0. The average hospital stay in each group was A: 6±2, B: 2±1, C: 1±0, D: 1.1±0 days. Patient’s acceptance was good with Harmonic Scalpel hemorrhoidectomy and Laser hemorrhoidectomy technique due to least complication rates and early return to work as compared to open and stapler hemorrhoidectomy.

Results :In our study the majority of patients fall in the age group of 30 to 60 years with mean age of 42.39 years .Around 74.50% were males and 25.50% were females. The average operating time was for group A : 51.8 ±9.34,B : 41.37 ±6.09 ,C : 17.6±4.11, D:22.25±3.98 .VAS pain score postoperative day1,week 1,week4,week12 were for Group A:5.64±1.25,4.16 ±1.11,2.68 ±0.99,1.16 ±0.8.Group B:3.5 ±1.32, 2 ±0.83,1.12 ±0.34,0.12 ±0.34.Group C: 2.7±1.16,0.92 ±1.0,0,0.Group D: 3.9±0.97,2 .15±0.87, 0.51 ±0.5,0. The average hospital stay in each group was A: 6 ± 2,B: 2 ± 1,C: 1 ± 0, D: 1.1 ± 0 days.

Conclusion: Patient’s acceptance was good with Harmonic Scalpel Hemorrhoidectomy and Laser Hemorrhoidectomy technique due to least complication rates and early return to work as compared to open hemorrhoidectomy and stapler hemorrhoidectomy.

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