Haemorrhoidectomy For Advanced Haemorrhoidal Disease Comparative Study Between The Conventional And Modern Techniques
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Surgical excision is considered the ideal treatment for the third and fourth degree haemorrhoids. Inspit of being safe, surgical excision is liable to some complications as postoperative bleeding, pain, discharge, stenosis and recurrence. So, a wide variety of techniques had been developed to avoid these complications. This study was performed for two hundred patients complaining of third or fourth degree haemorrhoidal disease. Their ages ranged between 18 and 66 years, (mean 40.28 11.84 years). The patients were divided into four groups. Group 1, (50 patients), for whom stapler haemorrhoidectomy was done. Group II, (50patients), for whom rubber band ligation was performed. Group III, (50 patients), for whom Good-Sail's stitch technique was done. Group IV (50 patients), for whom conventional haemorrhodectomy was performed. The aim of this study was evaluation of the four techniques regarding, the operative time, hospital stay, time off-work, postoperative pain, bleeding and postoperative complications. For each technique the study concluded that: The shortest mean operative time was in group II, (5.7 2.14 mins.J. The shortest hospital stay and shortest time-off work was in group II, (1.60 0.91 days) and (3.12 1.39 days) respectively. Minimal post operative pain was in group I. The highest incidence of postoperative minor bleeding, pruritis and wound discharge was recorded in group IV. The highest incidence of recurrence was recorded in group II The results seen with stapler haemorrhoidectomy are very promising and actually superior to that of conventional haemorrhoidectomy. in treatment of third and fourth degrees haemorrhoidal disease. Cost which remains high, seems to be balanced by the superior results obtained and the significant rapid return to normal activities and patient satisfaction.