Abstract

Conventional/Milligan-Morgan hemorrhoidectomy was the most popular surgical hemorrhoid treatment until recently after the introduction of minimally invasive surgery which made stapler hemorrhoidectomy a popular daycare technique with minimum complications. Aim: To comparatively assess the conventional hemorrhoidectomy to stapled hemorrhoidectomy for surgical management of the hemorrhoids. Methods: 100 subjects scheduled for hemorrhoidectomy were divided into 2 groups of 50 subjects each where the group I subjects underwent stapled hemorrhoidectomy and group II subjects conventional hemorrhoidectomy. All subjects were assessed for anal stenosis, anal incontinence, urinary retention, wound infection, bleeding, and postoperative pain at 1st and 3rd weeks postoperative. Results: Mean operative time was higher with the conventional technique with 45.77±5.88 minutes compared to stapler hemorrhoidectomy. VAS scores on days 1 and 3 were significantly higher in conventional hemorrhoidectomy compared to stapler hemorrhoidectomy with p<0.001. Hospital stay duration was significantly more for conventional hemorrhoidectomy in comparison to stapler hemorrhoidectomy with mean stay duration of 7.22±2.4 and 3.01±2.1 days respectively with p<0.01. The time to return to normal activities was lesser with stapler hemorrhoidectomy than with conventional hemorrhoidectomy (p<0.01). Postoperative bleeding was significantly higher in subjects who underwent conventional hemorrhoidectomy, anal stenosis was seen in 4% (n=2) subjects with conventional hemorrhoidectomy, anal incontinence in 8% (n=4) subjects of conventional hemorrhoidectomy, and wound infection in 8% (n=4) subjects of conventional hemorrhoidectomy. Conclusion: Stapler hemorrhoidectomy has lesser postoperative pain, hospital stay duration, and operative time with a faster return to normal activity. Hence, stapler hemorrhoidectomy is recommended in subjects undergoing hemorrhoidectomy

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