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 I, (50 patients), for whom stapler haemorrhoidectomy was done. Group II, (50 patients), for
whom rubber band ligation was petformed. Group III, (50 patients), for whom Good-Sal! '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 11, (5.7 ± 2.14 mins). 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. |
