Abstract
Back ground: Haemorrhoids are commonly encountered in routine colo rectal outpatient department. It is most common cause of rectal bleeding. Haemorrhoidectomy is an operation for third and fourth degree Haemorrhoids. This is the comparative study in between open and closed method Haemorrhoidectomy. The comparison has been done with post operative pain, bleeding, operative time, duration of stay, and wound healing in patients undergoing open and closed method Haemorrhoidectomy.
Method: 80 patients with third and fourth degree Haemorrhoids were randomly divided in two group A (open Haemorrhoidectomy) and group B (closed Haemorrhoidectomy).Data such as personnel data, type of anaesthesia, type of operation, post operative bleeding, analgesic requirement for post operative pain, operation time, hospital stay and wound healing were collected.
Results: Mean operating time was shorter in open method as compare to closed method. Analgesic requirement were less in the closed method. Healing time was shorter in closed method.
Conclusion: The closed method is associated with less pain during early post operative period and faster wound healing.
Keywords: Haemorrhoids, Open, Closed, Pain, Healing time.
References
1. Bullard K M., Rothenberger D.A. colon rectum and anus in : Brunicardi F. C, Andersen D. K Schwartz’s principles of surgery , 8 th. Edition , newwork, McGraw-Hill Book company, 2005; 1101-1103.
2. Wexner SD. The quest for painless surgical treatment of hemorrhoids continue. J Am coll Surg 2001; 193:174-8.
3. Ferguson EF Jr. Alternatives in the treatment of Hemorrhoidal Disease. South Med J 1988; 81 : 606-10.
4. Konsten J, Baeten CG. Hemorrhoidectomy vs Lord’s method: 17 year follow –up a prospective, randomized trial. Dis Colon Rectum 2000;43:503-6.
5. Shoaib M, Ali AA, Naqvi N, GondalKM, Chaudhary AM. Open versus closed haemorrhoidectomy, an experience at Mayo hospital. Ann KE Med Coll 2003;9:65-8.
6. Aroya A, Perez F, Miranda E, Serrano P, Candela F, Lacueva J et al. Open versus closed day case haemorrhoidectomy: is there any difference? Results of a prospective randomized study. Int J Colorectal Dis 2004;19:370-3.
7. Ahmad AN, Fatima N, Hussain RA, Chaudhary ZA, Quadir SNR. Strength and limitation of closed versus open haemorrhoidectomy of 2nd and 3rd degree. Ann KE Med Coll 2003;9:219-20.
8. Kim SH, Chung CS. Open versus closed Hemorrhoidectomy. Dis Colon Rectum 2005;48:108-113.
9. Ferguson JA, Heaton JR. closed Hemorrhoidectomy. Dis Colon Rectum1959;2:176-9.
10. Bledy R, Pena JP, Rothenberger DA, Goldberg SM, Buls JG. Symptomatic hemorrhoids: current incidence and complication of operative therapy Dis Colon Rectum, 1992;35:477-81.
11. Khubchandani IT, Trimpi HD, Sheets JA. Closed hemorrhoidectomy with local anaesthesia. Surg Gynecol Obstetric 1972;135:955-7.
12. Hosch SB, Knoefel WT, Pichlmeier U, et al. Surgical treatment of piles: Dis Colon Rectum 1998;41:159-64.
13. You S.Y., Kim S. H., Chung C.S. Open vs. closed Hemorrhoidectomy. Dis. Colon Rectum2005;48:108-113.
14. Arbman G, Krook H, Haapaniemi S. closed vs. open Hemorrhoidectomy: is there any difference? Dis. Colon Rectum2000;43:31-4.
15. Carapeti EA, Kamm MA, McDonald PJ, Chadwik SJ, Phillips RK. Randomized trial of open versus closed Day-case hemorrhoidectomy. Br J Surg 1999;86:612-3.
16. Gencosmanoglu R, Sad O, Koc D, Inceoglu R. Hemorrhoidectomy: open or closed technique? A prospective randomized clinical trial. Dis colon rectum 2002;45:70-5.
17. Wolfe JS, Munoz JJ, Rosin JD. Survey Hemorrhoidectomy practice open versus closed techniques. Dis colon rectum 1979;22:536-8.