Comparison of Postoperative Pain in Open Hemorrhoidectomy with and without Lateral Internal Sphincterotomy

Background: Hemorrhoids are a prevalent human ailment, and there are limited options available for traditional open surgical procedures. The primary complication frequently associated with open surgical procedures is the discomfort resulting from the contraction of the inner sphincter muscle. Performing a lateral internal sphincterotomy is a common procedure aimed at alleviating spasm and pain. The study aim was to compare the open hemorrhoidectomy with and without lateral internal sphincterotomy. Study type, settings & duration: This comparative randomized control trial was done at the Department of General Surgery, Akbar Niazi Teaching Hospital, Islamabad from September 2022 to September 2023. Methodology: Consecutively enrolled patients who underwent surgical intervention for 3rd and 4th degree hemorrhoids at the hospital were included, with the option of either receiving lateral internal sphincterotomy or undergoing the procedure without it. A total of 40 patients, ages 20-60 years were selected while adhering to the inclusion criteria of the study. There were 20 patients in the open hemorrhoidectomy-only group (Group A), while another 20 patients were in the open hemorrhoidectomy group (Group B), which included lateral internal sphincterotomy. The data underwent analysis using SPSS v 25. Results: The patients mean age was 38.66±9.32 years, 70% (n=28) were male, while the remaining 30% (n=12) were female. Group-B patients reported lower postoperative pain levels compared to those in Group-A. Upon final assessment, we identified 17 patients in group-B who reported being entirely free of pain, while in group-A, there were 9 patients with the same outcome. During the postoperative...........