A STUDY TO COMPARE STAPLER HAEMORRHOIDECTOMY VS CONVENTIONAL HAEMORRHOIDECTOMY

Introduction: Until recently, Milligan-Morgan hemorrhoidectomy, known as conventional or open hemorrhoidectomy, was the predominant surgical treatment for hemorrhoids. However, with the emergence of minimally invasive techniques, the landscape has shifted. In recent years, stapled hemorrhoidectomy has gained popularity as a day surgery option due to reduced post-operative pain and quicker return to normal activities. This study aims to compare stapled hemorrhoidectomy with conventional hemorrhoidectomy in the surgical management of hemorrhoids. Material & Methods: A hospital based non-randomised comparative study was conducted in Dept. of Surgery of at a tertiary care hospital. A total of 120 eligible cases scheduled for haemorrhoidectomy in our hospital were included in the study. These 120 patients were then divided into two groups i.e. 60 for stapled procedure and other 60 patients for conventional procedure Data were analysed using statistical software SPSS ver. 26. Results: Mean operative time was significantly less in stapler group (38.7 vs 48.02 mins; p<0.0001) while mean hospital stay was significantly longer in conventional surgery group (6.17 vs 2.20 days; p<0.0001). Post-op complains of pain, immediately after surgery (6 hrs.) and at day 1 and day 3 was significantly less in stapler group (p<0.0001). Post-op complications after conventional surgery include bleeding (30%), urinary retention (10%), wound infection, anal incontinence (10% each) and anal stenosis (7%). Complications of stapler surgery include bleeding (15%) and urinary retention (7%). Mean time for return to work was significantly less in stapler group as compared to conventional surgery group (4.73 vs 13.58 days; p<0.0001). Conclusion: Stapler haemorrhoidectomy offers advantages such as reduced operative time, shorter hospital stays, decreased post-operative pain, and quicker return to normal activity. Therefore, it is recommended for all patients undergoing haemorrhoid surgery. However, larger prospective double-blind trials with longer follow-up periods are necessary to evaluate recurrence rates and assess costeffectiveness. These studies are crucial for gaining a comprehensive understanding of stapler haemorrhoidectomy's efficacy and economic impact compared to other treatment options.