COMPARATIVE STUDY OF DIFFERENT TREATMENT MODALITIES OUTCOMES FOR HEMORRHOIDAL DISEASE
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 31st 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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