Study of comparision between open and closed haemorrhoidectomy

INTRODUCTION: Haemorrhoids is one of the commonest clinical condition that we have come across in our surgical practice. It is one of the commonest troublesome disease also. From the ancient days-that is from the period of Hippocrates-the piles was treated by many modalities (Smith 1961). Even at present it was claimed that all faculty of medicine-sidha, Ayurvedha and Homeo -Successfully in practices. But most of them are not proven one with scientific data. In Allopathy even though conservative managements are successful, in most of the cases surgery becomes the main stay of treatment. AIM OF THE STUDY: This is a prospective study of comparison between OPEN VS CLOSED HAEMORRHOIDECTOMY done with the patients admitted in TMCH during the period of 2010-2013. 1. Post operative pain, 2. postoperative healing, 3. post operative soiling, 4. post operative follow up. METHODS AND MATERIALS: Haemorrhoidectomy is the treatment of choice for patients with 2nd and 3rd degree Hemorrhoids. The purpose of this study was to compare these techniques with respect to operating time, post operative complication such as pain, soiling, healing, hospitals stay, duration of inability to work, healing time, and other late complications of surgery. METHODS: In this prospective randomized study, 100 patients with IInd and III rd Degree Hemorrhoids were selected. Group I having 50 patients were treated with open Haemorrhoidectomy and Group II having 50 patients were treated with closed Haemorrhoidectomy. open Haemorrhoidectomy was performed according to Milligan Morgan operation. Closed Haemorrhoidectomy was done according to Ferguson technique. INCLUSION CRITERIA: Patients with complaints of bleeding per rectum, mass per rectum, pain, irritation, discharge per rectum. Patients with 2nd and 3rd degree hemorrhoids are suitable for surgery. EXCLUSION CRITERIA: Haemorrhoids associated with complications (ulceration, recurrent cases, strangulation). CONCLUSION: The following are the findings in our study of 100 patients with haemorrhoids treated at Thanjavur Medical College Hospital, Thanjavur during the period 2010-2013. 1. Post operative pain was significantly lower in closed method when compared to open method. 2. Pain and soiling are lower in closed method compared to open method after 3to 6 weeks follow up. 3. Wound healing was better in closed method compared to open method after 3 to 6 weeks follow up. 4. After 3 months follow up, closed method shows better outcome compared to the open method. 5. The operating time was slightly lower in open haemorrhoidectomy than in closed haemorrhoidectomy. 6. The peak age incidence is in between 40-50 years. There is male preponderance. 7. Most of our patients had bleeding and prolapse as presenting features. Familial preponderance in our study is only 2%