A COMPARISON BETWEEN OPEN AND CLOSED HEMORRHOIDECTOMY
Abstract
Background: Haemorrhoidectomy is associated with complications including pain, bleeding andwound infection which can result prolonged hospital stay. Haemorrhoidectomy is considered to providea better outcome in terms of postoperative pain and wound healing. Aims were to comparepostoperative pain, bleeding, operating time and wound healing in patients undergoing open and closedhaemorrhoidectomy. Methods: This comparative study was conducted in the surgical department atFauji Foundation Hospital, Rawalpindi from December 13, 2006 to December 31, 2011. Consecutivepatients, both male and female, presenting with 3rd and 4th degree haemorrhoids in the surgical Outpatient Department were included in this study. Half of the patients were assigned to the openhaemorrhoidectomy group while the other half was put in the closed haemorrhoidectomy group. Eachpatient was evaluated by detailed history and examination. Both digital rectal examination (DRE) andproctoscopy were done to confirm the diagnosis. Results: A total of 260 patients were assessed, 130 ineach group. In the open group, 52 patients experienced mild pain and 78 moderate while in the closedgroup, 30 patients experienced mild pain, 87 moderate and 13 patients severe pain. All 130 patients inthe closed group showed complete wound healing after 2 weeks as compared to only 66 patients in theopen group with a p<0.001. Early and late postoperative bleeding was similar in both groups.Conclusions: The closed technique provides a better outcome in terms of less postoperative bleedingand complete wound healing, but it is associated with more pain.Keywords: Open haemorrhoidectomy, closed haemorrhoidectomy, postoperative, painReferences
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