COMPARISON OF PILE SUTURING VS HEMORRHODECTOMY FOR THE MANAGMENT OF THIRD- AND FOURTH-DEGREE HAEMORRHOIDS

Objective: This study aimed to compare the outcomes of pile suturing and hemorrhoidectomy in the management of third- and fourth-degree hemorrhoids, focusing on operating time, hospital stay, post-operative pain and complications. Methodology: This study included 70 adult patients diagnosed with third- or fourth-degree hemorrhoids. Participants were assigned to either pile suturing (Group A) or hemorrhoidectomy (Group B). Surgical procedures were performed under regional or general anesthesia. The primary outcome measures included operating time, hospital stay, and pain levels assessed using the visual analogue scale (VAS) at a two-week follow-up. Secondary outcomes included complications. Results: The mean operating time for pile suturing was significantly shorter (28.94 ± 3.226 minutes) compared to hemorrhoidectomy (49.89 ± 2.938 minutes) (P = 0.0001). The average hospital stay was also shorter for the pile suturing group (3.54 ± 1.221 days) compared to the hemorrhoidectomy group (5.86 ± 0.772 days) (P = 0.0001). Post-operative pain at two weeks was lower in the pile suturing group (0.86 ± 0.733) compared to the hemorrhoidectomy group (1.49 ± 1.011) (P = 0.004). Complications were significantly fewer in the pile suturing group, with 5.7% experiencing bleeding compared to 22.9% in the hemorrhoidectomy group (P = 0.04). Recurrence rates were similar between the groups. Conclusion: Pile suturing demonstrated superior short-term outcomes, including reduced operating time, hospital stay, pain, and bleeding, compared to hemorrhoidectomy. While recurrence rates were comparable, pile suturing offers a less invasive and quicker recovery alternative for patients with third- and fourth-degree hemorrhoids.