IS STAPLED HEMORRHOIDECTOMY A SAFE PROCEDURE FOR THIRD AND FOURTH GRADE HEMORRHOIDS

Objective: To compare the complications of Stapled Hemorrhoidectomy procedure among the patients of grade 3 and 4 hemorrhoids at a tertiary care teaching hospital of Pakistan. Study Design: Observational study. Place and Duration of Study: Combined Military Hospital Rawalpindi, from 01 Jan 2018 to 31 Oct 2018. Material and Methods: A prospective study was conducted on 87 patients of grade 3 and 4 hemorrhoids diagnosed by consultant surgeon undergoing Stapled Hemorrhoidectomy at surgical unit of CMH RWP during the study period. Longos technique was used to perform the hemorrhoidectomy. Detailed assessment regarding all the complications was done immediately after the procedure at 48 hours, at time of discharge and two weeks after the procedure. VAS score was applied to assess the post-operative pain. Results: A total of 87 patients were included in the final analysis that underwent the staple hemorrhidectomy. Male to female ratio was 1.71:1. Post-operative pain was the commonest complication among the target population followed by bleeding. Mean age of patients who underwent the surgery was 41.13 (± 5.995). Most of the patients had grade three hemorrhoids. Out of 87 patients, 06 (6.9%) had bleeding, 11 (12.6%) had post-operative pain, 04 (4.6%) had prolapse and 03 (3.4%) had anal stenosis. Conclusion: Stapled hemorrhidectomy emerged as a safe and feasible technique for grade 3 & 4 hemorrhoids in our population. It should be preferred over the conventional hemorrhoids surgery in order to minimize the post-operative complications and improve the comfort of the patient. Special attention should be given.........