Comparison of Outcomes between Open and Closed Haemorrhoidectomy

Outcomes of Open and Closed Haemorrhoidectomy

Authors

  • Khalid Mahmood Department of Surgery, Niazi Medical and Dental College, Sargodha, Pakistan
  • Muhammad Iqbal Department of Surgery, Bolan Medical Complex Hospital, Quetta, Pakistan
  • Ahmed Hassan Khan Department of Surgery, Sargodha Medical College, District Headquarter Hospital, Sargodha, Pakistan
  • Allah Nawaz Department of Surgery, Sargodha Medical College, District Headquarter Hospital, Sargodha, Pakistan
  • Raza Farrukh Department of Anaesthesia, Sargodha Medical College, District Headquarter Hospital, Sargodha, Pakistan
  • Khawaja Arshad Department of Paediatrics, Sargodha Medical College, District Headquarter Hospital, Sargodha, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i10.1681

Keywords:

Hemorrhoidectomy, Postoperative Pain, Wound Healing, Pain Perception

Abstract

Horrhoidectomy can prolong hospital stays due to pain, bleeding, and wound infections. Horrhoidectomy improves postoperative pain and wound healing. This research examined postoperative pain, hemorrhage, operating time, and wound healing after open and closed hemorrhoidectomy. Objective: To determine the post-operative outcomes of open and closed haemorrhoidectomy in terms of wound healing, pain perception and complications. Methods: This comparative study was conducted at Department of Surgery, DHQ Teaching Hospital, Sargodha from 1st September 2022 to 28th February 2023. Sixty patients were selected and divided into two groups; open and closed haemorrhoidectomy. Grade-III and grade-IV patients were underwent haemorrhoidectomy on the basis of severity and internal haemorrhoids. SPSS version 26.0 was used to analyse all the data. Results: There were 40 (66.7%) males and 20 (33.3%) females. Approximately 43.3% of the patients from closed group showed mild pain whereas 36.6% of the cases from open group complain mild pain after open haemorrhoidectomy. An open haemorrhoidectomy incision healed in 22 days, but a closed one took 15 days (p=0.56). The early onset of post-operative closed haemorrhoidectomy patients had 3.3%, 6.6%, and 3.3% cases of hemorrhoid, infection, and urinary retention, while the early onset of open patients had 6.6%, 10%, and 6.6%. There was just one patient in the open haemorrhoidectomy group with late-onset anal stenosis, and no other patient in either group developed fissure or faecal incontinence. Conclusion: Almost similar pain perception was observed in both surgical procedures before and after the surgery.

References

Bakhtiar N, Moosa FA, Jaleel F, Qureshi NA, Jawaid M. Comparison of hemorrhoidectomy by LigaSure with conventional Milligan Morgan's hemorrhoidectomy. Pakistan Journal of Medical Sciences. 2016 May; 32(3): 657. doi: 10.12669/pjms.323.9976.

Naeem Ghaffar MA, Abbas K, Asif K. Comparison between open Haemorrhoidectomy versus closed Haemorrhoidectomy. Pakistan Journal of Medical & Health Sciences. 2022 Jun; 16(05): 219. doi: 10.53350/pjmhs22165219.

Mohapatra R, Murmu D, Mohanty A. A comparative study of open and closed hemorrhoidectomy. International Surgery Journal. 2018 Jun; 5: 2335-8. doi: 10.18203/2349-2902.isj20182249.

Naeem Ghaffar MA, Abbas K, Asif K. Comparison between open Haemorrhoidectomy versus closed Haemorrhoidectomy. Pakistan Journal of Medical & Health Sciences. 2022 Jun; 16(05): 219-. doi: 10.53350/pjmhs22165219.

Mohapatra R, Murmu D, Mohanty A. A comparative study of open and closed hemorrhoidectomy. Journal of International Surgery. 2018 Jun; 5(6): 2335-2338. doi: 10.18203/2349-2902.isj20182249.

Arbman G, Krook H, Haapaniemi S. Closed vs. open hemorrhoidectomy-is there any difference?. Diseases of the Colon & Rectum. 2000 Jan; 43: 31-4. doi: 10.1007/BF02237240.

Kibret AA, Oumer M, Moges AM. Prevalence and associated factors of hemorrhoids among adult patients visiting the surgical outpatient department in the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. PLOS One. 2021 Apr; 16(4): e0249736. doi: 10.1371/journal.pone.0249736.

Ferguson JA and Heaton RJ. Closed hemorrhoidectomy. Diseases of the Colon & Rectum. 1959 Mar; 2(2): 176-9. doi: 10.1007/BF02616713.

Agarwal N, Singh K, Sheikh P, Mittal K, Mathai V, Kumar A. Executive Summary-The Association of Colon & Rectal Surgeons of India (ACRSI) Practice Guidelines for the Management of Haemorrhoids-2016. Indian Journal of Surgery. 2017 Feb; 79: 58-61. doi: 10.1007/s12262-016-1578-7.

Khalil-ur-Rehman, Hasan A, Taimur M, Imran M. A comparison between open and closed hemorrhoidectomy. Journal of Ayub Medical College Abbottabad. 2011 Jan-Mar; 23(1): 114-6.

Naik SA and Neelima M. A comparative study of closed versus open haemorrhoidectomy. International Surgery Journal. 2018 Jul; 5(8): 2803-7. doi: 10.18203/2349-2902.isj20183195.

Bhatti MI, Sajid MS, Baig MK. Milligan-Morgan (open) versus Ferguson haemorrhoidectomy (closed): a systematic review and meta-analysis of published randomized, controlled trials. World Journal of Surgery. 2016 Jun; 40: 1509-19. doi: 10.1007/s00268-016-3419-z.

Lohsiriwat V. Hemorrhoids: from basic pathophysiology to clinical management. World Journal of Gastroenterology. 2012 May; 18(17): 2009-17. doi: 10.3748/wjg.v18.i17.2009.

Singh R, Reddy TR, Kumar TS. A comparative study of open (Milligan-Morgan) versus closed (Ferguson) haemorrhoidectomy with and without internal sphincterotomy. International Surgery Journal. 2019 Jan; 6(2): 443-6. doi: 10.18203/2349-2902.isj20190078.

Elhefny AM, Shoka AA, Elghandour AM, Hamed MA. A comparative study between stapled hemorrhoidopexy and laser hemorrhoidoplasty in the treatment of second-degree and third-degree hemorrhoids. The Egyptian Journal of Surgery. 2021 Oct; 40(4): 1046-55. doi: 10.4103/ejs.ejs_79_21.

Selvarajan R. Efficacy of haemorrhoidectomy versus haemorrhoidectomy with internal sphincterotomy in treatment of haemorrhoids: a retrospective randomized controlled trial study. International Surgery Journal. 2021 Feb; 8(3): 839-43. doi: 10.18203/2349-2902.isj20210913.

Nada EF, Mohamed H, Mohammad H, Elhendawey EI. A Comparative Study between Stapled and Harmonic Hemorrhoidectomy for Treatment of Third-and Fourth-Degree Piles. The Egyptian Journal of Hospital Medicine. 2022 Oct; 89(1): 4985-92. doi: 10.21608/ejhm.2022.260870.

Ruan QZ, English W, Hotouras A, Bryant C, Taylor F, Andreani S et al. A systematic review of the literature assessing the outcomes of stapled haemorrhoidopexy versus open haemorrhoidectomy. Techniques in Coloproctology. 2021 Jan; 25: 19-33. doi: 10.1007/s10151-020-02314-6.

Malyadri N and Allu VJ. A prospective comparative study of stapler hemorrhoidectomy vs open haemorrhoidectomy (Milligan Morgan) in its outcome and postoperative complications. Journal of Surgery and Research. 2021 Dec; 4(1): 4-13. doi: 10.26502/jsr.100200104.

Khan ZA, Razzaq SA, Zareen NA, Hussain A, Kashif M, Khan JI. Conventional hemorrhoidectomy versus stapled hemorrhoidopexy: compare the outcomes of both techniques in patients with grade III and IV hemorrhoids. Pakistan Journal of Medical & Health Sciences. 2020 Mar; 14: 588-91.

Salama MM, El Hossainy AF, Rihan M. Comparative study between stapled and open hemorrhoidectomy results with one-year follow-up. The Egyptian Journal of Surgery. 2023 Jul; 42(3): 627-34. doi: 10.4103/ejs.ejs_122_23.

Poskus T, Danys D, Makunaite G, Mainelis A, Mikalauskas S, Poskus E et al. Results of the double-blind randomized controlled trial comparing laser hemorrhoidoplasty with sutured mucopexy and excisional hemorrhoidectomy. International Journal of Colorectal Disease. 2020 Mar; 35: 481-90. doi: 10.1007/s00384-019-03460-6.

Naderan M, Shoar S, Nazari M, Elsayed A, Mahmoodzadeh H, Khorgami Z. A randomized controlled trial comparing laser intra-hemorrhoidal coagulation and Milligan-Morgan hemorrhoidectomy. Journal of Investigative Surgery. 2017 Sep; 30(5): 325-31. doi: 10.1080/08941939.2016.1248304.

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Published

2024-10-31
CITATION
DOI: 10.54393/pjhs.v5i10.1681
Published: 2024-10-31

How to Cite

Mahmood, K., Iqbal, M., Khan, A. H., Nawaz, A., Farrukh, R., & Arshad, K. (2024). Comparison of Outcomes between Open and Closed Haemorrhoidectomy: Outcomes of Open and Closed Haemorrhoidectomy. Pakistan Journal of Health Sciences, 5(10), 69–73. https://doi.org/10.54393/pjhs.v5i10.1681

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