A prospective randomized controlled trial comparing the immediate post-operative complications between open and semi-open hemorrhoidectomy

Introduction: Hemorrhoids are one of the most common anorectal pathologies encountered by general surgeons during their practice. Open technique as described by Milligan and Morgan and closed technique as described by Ferguson are the most widely used. A semi-open technique that has lesser complica...

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Autores principales:	Bhuban Rijal, Robin Bahadur Basnet
Formato:	article
Lenguaje:	EN
Publicado:	Society of Surgeons of Nepal 2019
Materias:	Hemorroids Open Hemorroidectomy Semi-open Haemorroidectomy Surgery RD1-811
Acceso en línea:	https://doaj.org/article/0313b67199f44389a04430575e7a6b79
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spelling	oai:doaj.org-article:0313b67199f44389a04430575e7a6b792021-12-05T19:15:51ZA prospective randomized controlled trial comparing the immediate post-operative complications between open and semi-open hemorrhoidectomy10.3126/jssn.v22i1.287111815-39842392-4772https://doaj.org/article/0313b67199f44389a04430575e7a6b792019-12-01T00:00:00Zhttps://www.nepjol.info/index.php/JSSN/article/view/28711https://doaj.org/toc/1815-3984https://doaj.org/toc/2392-4772 Introduction: Hemorrhoids are one of the most common anorectal pathologies encountered by general surgeons during their practice. Open technique as described by Milligan and Morgan and closed technique as described by Ferguson are the most widely used. A semi-open technique that has lesser complications than the conventional open hemorrhoidectomy has been described. This study aims to compare the immediate postoperative complications between open and semi-open hemorrhoidectomy. Methods: A prospective randomized study, where patients with third and fourth-degree hemorrhoids undergoing hemorrhoidectomy, were taken for the study. The subjects were randomized into two groups, where they underwent either open or semi-open hemorrhoidectomy. Both groups received standard postoperative care and were evaluated after 24 hours after surgery for pain and urine retention and were then discharged with the same treatment plan for both groups. First, follow up was done in one week and the second was done in two weeks after discharge, where pain score, bleeding, wound healing, use of narcotic analgesics and patient discomfort were recorded. Results: A total of 44 patients were divided into two groups, where the age, sex, and grade of hemorrhoids were matched. The pain score using VAS in the first week was compared and it showed that the pain perceived by the patients in the open hemorrhoidectomy was greater than in the semi-open method ((p=0.06, 95% CI= 0.22 to 1.23). Bleeding rate after the surgeries were not different between the two groups (p=0.43) and the urinary retention between them was also not significant (p=0.47). The use of breakthrough narcotic analgesics was more in the open hemorrhoidectomy group (p=0.01). On the fourteenth day follow up, the wound of those who underwent semi-open hemorrhoidectomy, had significantly healed as compared to those who had undergone the open procedure (p= 0.04, 95% CI=0.23 to 0.76), and the patients who had semi-open hemorrhoidectomy had lesser discomfort as compared to the open technique (p=0.02). Conclusion: Semi-open hemorrhoidectomy has fewer post-operative complication rates as compared to open hemorrhoidectomy with decreased pain, faster wound healing rates, and lesser patient discomfort. Bhuban RijalRobin Bahadur BasnetSociety of Surgeons of NepalarticleHemorroidsOpen HemorroidectomySemi-open HaemorroidectomySurgeryRD1-811ENJournal of Society of Surgeons of Nepal, Vol 22, Iss 1 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Hemorroids Open Hemorroidectomy Semi-open Haemorroidectomy Surgery RD1-811
spellingShingle	Hemorroids Open Hemorroidectomy Semi-open Haemorroidectomy Surgery RD1-811 Bhuban Rijal Robin Bahadur Basnet A prospective randomized controlled trial comparing the immediate post-operative complications between open and semi-open hemorrhoidectomy
description	Introduction: Hemorrhoids are one of the most common anorectal pathologies encountered by general surgeons during their practice. Open technique as described by Milligan and Morgan and closed technique as described by Ferguson are the most widely used. A semi-open technique that has lesser complications than the conventional open hemorrhoidectomy has been described. This study aims to compare the immediate postoperative complications between open and semi-open hemorrhoidectomy. Methods: A prospective randomized study, where patients with third and fourth-degree hemorrhoids undergoing hemorrhoidectomy, were taken for the study. The subjects were randomized into two groups, where they underwent either open or semi-open hemorrhoidectomy. Both groups received standard postoperative care and were evaluated after 24 hours after surgery for pain and urine retention and were then discharged with the same treatment plan for both groups. First, follow up was done in one week and the second was done in two weeks after discharge, where pain score, bleeding, wound healing, use of narcotic analgesics and patient discomfort were recorded. Results: A total of 44 patients were divided into two groups, where the age, sex, and grade of hemorrhoids were matched. The pain score using VAS in the first week was compared and it showed that the pain perceived by the patients in the open hemorrhoidectomy was greater than in the semi-open method ((p=0.06, 95% CI= 0.22 to 1.23). Bleeding rate after the surgeries were not different between the two groups (p=0.43) and the urinary retention between them was also not significant (p=0.47). The use of breakthrough narcotic analgesics was more in the open hemorrhoidectomy group (p=0.01). On the fourteenth day follow up, the wound of those who underwent semi-open hemorrhoidectomy, had significantly healed as compared to those who had undergone the open procedure (p= 0.04, 95% CI=0.23 to 0.76), and the patients who had semi-open hemorrhoidectomy had lesser discomfort as compared to the open technique (p=0.02). Conclusion: Semi-open hemorrhoidectomy has fewer post-operative complication rates as compared to open hemorrhoidectomy with decreased pain, faster wound healing rates, and lesser patient discomfort.
format	article
author	Bhuban Rijal Robin Bahadur Basnet
author_facet	Bhuban Rijal Robin Bahadur Basnet
author_sort	Bhuban Rijal
title	A prospective randomized controlled trial comparing the immediate post-operative complications between open and semi-open hemorrhoidectomy
title_short	A prospective randomized controlled trial comparing the immediate post-operative complications between open and semi-open hemorrhoidectomy
title_full	A prospective randomized controlled trial comparing the immediate post-operative complications between open and semi-open hemorrhoidectomy
title_fullStr	A prospective randomized controlled trial comparing the immediate post-operative complications between open and semi-open hemorrhoidectomy
title_full_unstemmed	A prospective randomized controlled trial comparing the immediate post-operative complications between open and semi-open hemorrhoidectomy
title_sort	prospective randomized controlled trial comparing the immediate post-operative complications between open and semi-open hemorrhoidectomy
publisher	Society of Surgeons of Nepal
publishDate	2019
url	https://doaj.org/article/0313b67199f44389a04430575e7a6b79
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A prospective randomized controlled trial comparing the immediate post-operative complications between open and semi-open hemorrhoidectomy

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