AN OBSERVATIONAL COMPARATIVE STUDY OF STAPLER HEMORRHOIDOPEXY AND THE MILLIGAN MORGAN OPEN HEMORRHOIDECTOMY IN TERTIARY CARE CENTER OF CENTRAL INDIA

Introduction: Hemorrhoids also called piles. It is vascular structures in the analcanal. In their normal state, they are cushions that help with stool control. They become a disease when swollen or inflamed. the unqualified term "hemorrhoid" is often used to refer to the disease.

Material and method: The present study was conducted in the Department of Surgery, Sri Aurobindo Medical College & PG Institute Indore M.P over a duration of one and half years (November 2017 to May 2019). The study was a cross-sectional prospective study and it compares results between Milligan Morgan haemorrhoidectomy and Stapler haemorrhoidopexy for the management of grade 2, 3, and 4 hemorrhoids.

Results: In this study, most of the cases were between age group 30-50 [50%] years with the mean age being 43 years. Hemorrhoids more common in males 30 [65%], male: female ratio being 3:1. The most common presentation in hemorrhoids was bleeding per rectum in 47% followed by something coming out per rectum in 43 % & painful defecation in 10 % cases respectively. The duration of surgery was significantly low in the stapler group with meantime being 44.25 compared to open group 63 with the mean difference being 19 mins (P < 0.001). In 17of 21 [85%] whereas in grade IV all 09 [100%] patients had open surgery grade III had mixed options 03/07 [30/70 %] stapler & open respectively. Postoperatively the mean duration of hospital stay in stapler group was 4.15± 1.03 as compared to the open group 6.05 ± 1.84 with the mean difference being 2 days (P<0.001). The duration of recovery was significantly faster in stapler group with the mean hospital stay being 7.55 as compared to the open group 12.45 with mean difference being 5 days(P<0.001). Postoperative bleeding was found in both the groups which eventually subsided completely in stapler group on POD - 7 and only 3[7.5%]. Patients had bleeding on POD – 7 in the open group. (P < 0.001). The findings were statistically significant as suggested by P-Value. Urinary Retention was found in both groups i.e. 5% and 7.5% in stapler and open group respectively. (P= 0.632).

Conclusion: The results of this study concluded that Stapler hemorrhoidopexy had lesser operating time, lower duration of hospital stays, and quicker recovery with less postoperative pain & bleeding as compared to Open hemorrhoidectomy. Hence it was concluded that stapler hemorrhoidopexy is a better option as compared to open hemorrhoidectomyfor grade II. grade III, & a few selected cases of grade IV hemorrhoids. patients stapler procedure was choice in grade II haemorrhoids.