Surgical Treatment Of Haemorrhoids: Stapled Haemorrhoidopexy Versus Conventional Excisional Haemorrhoidectomy - A Clinical Outcome Analysis

Background: Hemorrhoids are a common anorectal condition that often requires surgical intervention for thirddegree cases when conservative treatments fail. Although both stapled haemorrhoidopexy and conventional excisional hemorrhoidectomy are widely used, uncertainty remains about which technique is superior. This study compares the short- and long-term outcomes of these procedures, focusing on recovery time, pain, and complications to clarify the optimal surgical approach. Materials and Methods: An open-label randomized controlled trial was conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU) over 12 months. Eighty-two patients with third-degree hemorrhoids were randomly assigned to undergo either stapled haemorrhoidopexy or conventional excisional hemorrhoidectomy. Primary outcomes were operating time, postoperative pain, and recovery period, while secondary outcomes included symptom improvement and complications. Data analysis was performed using SPSS, with statistical significance set at p < 0.05. Results: Group A had a significantly shorter operating time (16.5 vs. 25 minutes, p = 0.001) and less postoperative pain, with 42.9% reporting severe pain at 4 hours post-surgery compared to 95.2% in Group B (p = 0.001). By day 15, 95.2% of Group A experienced mild pain, while 64.3% of Group B still reported moderate pain (p = 0.001). Group A also had a faster recovery, with a median pain-free defecation time of 7 days versus 18.5 days for Group B (p = 0.001). Urinary retention was more common in Group B (50% vs. 19%, p = 0.003), while recurrence of mucosal prolapse was lower in Group A (21.4% at 6 months, p < 0.01). Conclusion: Stapled haemorrhoidopexy provides faster recovery and less pain but has a lower recurrence of mucosal prolapse compared to conventional hemorrhoidectomy. Surgical decisions should balance short-term benefits with long-term risks.