Outcomes after Hemorrhoidectomy with or Without Lateral Sphincterotomy: An Observational Study
Author(s): Dharmoo Arija, Rekha Melwani, Sadaf Jabeen, Rajesh Kumar, Ihsanullah Sial, BushraTasneem and Adnan Anwar*
Abstract
Objective: Hemorrhoids are a common human disease for which the best option available for the surgical management has remained conventional open hemorrhoidectomy. The most common complication of open hemorrhoidectomy is postoperative pain caused by spasm of the internal sphincter. Lateral sphincterotomy is a commonly performed procedure for relieving spasm and pain. The main aim of our study was to compare the postoperative outcomes in patients treated with open hemorrhoidectomy and open hemorrhoidectomy with internal sphincterotomy. Methodology: This observational study was conducted in surgical unit 1 of Ghulam Mohammad Mahar Medical College (GMMC), Sukkur. Duration of the study was about 2 years from Nov 2016 to Dec 2018. The ethical approval was taken from Institutional Research and Ethical Committee of medical college of Sukkur. A total of 120 patients were chosen for this study.. The patients were categorized into group A and B. In Group A, only conventional open hemorrhoidectomy was performed. In Group B in addition to conventional open hemorrhoidectomy received lateral internal sphincterotomy Results: A total of 120 patients were included in the study with. Mean age of 35.76 ± 11.33 years and 35.38 ± 12.20 years in group A and B respectively. Pain was assessed at 2nd post-operative day (POD-2). In group A, moderate pain exist in 35(58.3%) cases while in group B, mild pain was found in 39(65.0%) cases with the (p<0.001) that was significant. Table III showed only 9(15.0%) cases had per rectal bleeding at 1st POD in group A while only 3(5.0%) cases had per rectal bleeding at 1st POD in group B with the (p=0.068) that was insignificant. Conclusion: This study concluded that in conventional open hemorrhoidectomy for 2nd, 3rd and 4th degree hemorrhoids addition of lateral sphincterotomy is an effective, convenient, and simple way to reduce the postoperative pain and postoperative complications like anorectal bleeding and improves wound healing.