Stapled Hemorrhoidopexy versus Traditional Hemorrhoidectomy: A Comparative Study of two Procedures in Advanced Hemorrhoids

Abstract

Aim: To prove that stapled hemorrhoidopexy has better clinical outcome and lesser complications as compared to traditional hemorrhoid surgery. Methods: This randomized controlled study was single blind and parallel group in nature. It was done in Mayo Hospital, Lahore from 2nd January 2013 to 18th March 2014. Two hundred and fifty eight adult patients aged 16 years or older suffering from advanced hemorrhoids were included. They were divided in two groups; each group comprised equal number of patients. Group A receive either traditional hemorrhoidectomy (TH) and group B received stapled hemorrhoidopexy (SH). These patients were followed up for 2 years after surgery (till 01-04-16). Out of 258 patients, 50 patients lost for follow up. Our variables of interest were recurrence, duration of surgery, post-operative pain and bleeding. Results: In TH group, 6.7% patients developed recurrence while it was 17.3% in SH group (2 sided sig. 0.019). Duration of surgery was significantly longer in TH group (mean time 30.4±5.3min) while in SH group it was 20.8±3.1min. Post operative pain was determined by using visual analogue scale (VAS). Mean VAS in TH group was 7.4±1.2 while in SH group, mean VAS was 7.1±1.3 (p-value 0.026). In TH group, 9.3% patients experienced post operative bleeding while in SH group, it was 3.9% (2 sided sig. 0.079). Conclusion: Stapled hemorrhoidopexy had lesser overall complications than traditional hemorrhoidectomy seen on short term follow up. On the other hand, recurrence rate was more in the SH group than TH group. As recurrence is a long term complication so TH must be considered a much better surgery than SH.