Laparoscopic Versus Open Appendectomy for the Treatment of Complicated Acute Appendicitis

2020 ◽  
Vol 8 (1) ◽  
pp. 15
Author(s):  
Alireza Barband ◽  
Amir Mangouri ◽  
Changiz Gholipouri ◽  
Abasad Gharedaghi
Keyword(s):  
Laparoscopic Surgery ◽  
Surgical Treatment ◽  
Postoperative Pain ◽  
Acute Appendicitis ◽  
Open Surgery ◽  
Surgery Group ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Duration Of Hospitalization ◽  
Complicated Acute Appendicitis

Background and Objective: Acute appendicitis is one of the most common and at the same time lethal if not treated promptly. Failure to treat this medical condition in a timely manner then it can lead to major complications that endanger the patient’s health. In these cases, surgical treatment can be done in an open or laparoscopic method. Despite some limited studies comparing the results of these two therapies, there is still insufficient information in patients with this complicated situation. The aim of this study was to evaluate the results of these two therapies in patients with complicated acute appendicitis. Materials and Methods: In this randomized controlled clinical trial, 52 patients with complicated acute appendicitis in the laparoscopic surgery group and 56 patients in the open surgery group were studied. Primary outcomes in this study were duration of surgery and secondary outcomes including wound infection, intra-abdominal abscess, postoperative pain, miscarriage, hospitalization, and need for re-surgery that were compared between the two groups. Results: Both groups were matched for age (mean 31.0 years in laparoscopic surgery group, 30.5 years in open surgery group, p = 0.81) and gender (28 men in laparoscopic surgery group, 32 men in surgical group, p = 0.73). The mean duration of surgery in the laparoscopic group was significantly longer (mean 66.8 vs. 55.1 min, p <0.001). In contrast, mean duration of hospitalization (85.2 vs 98.6 hours, p <0.001) and mean postoperative pain severity (6.3 vs 7.2, p <0.001) was more significant high in open surgery group. In other cases there was no significant difference between the two groups. Conclusion: Although in surgical treatment of complicated acute appendicitis the duration of laparoscopic surgery is longer than the open method, but the duration of hospitalization and pain intensity in laparoscopic method is significantly reduced.

Assessment of Circumferential Resection Margins (CRM) clearance in Conventional open Versus Laparoscopic Cancer Rectum Resection

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ibrahim H Bayan ◽  
Ahmed Abdelaziz ◽  
Tarek Youssef Ahmed ◽  
Mohamed Magdy
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Abdominal Surgery ◽  
Open Surgery ◽  
Laparoscopic Group ◽  
Resection Margins ◽  
Laparoscopy Group ◽  
Surgery Group ◽  
Colon And Rectal Cancer ◽  
Significant Difference

Abstract Background Colon and rectal cancer represent the fourth commonest malignancy worldwide. Globally, colon and rectal cancer make up 9.4% and 10.1% in men and women of all cancers, respectively. Colon and rectal tumors are the third most common malignancy after breast and lung cancer, respectively. The main management of rectal cancer involves a multi-disciplinary team approach and an individually tailored treatment routine. Operative surgery remains the primary and definitive treatment for locally confined rectal adenocarcinoma and is the only historical and current treatment which allows for cure. Resection of the colon and rectal cancer can be done either by open surgical excision or laparoscopically. Aim of the work The objective is to compare the radicality of total mesorectal excision for rectal cancer in both open and laparoscopic surgery through the pathology report. Methods In this multicentric, prospective, comparative study, we included the pathologically established rectal cancer patients from 2 hospitals in Cairo, Egypt, Ain Shams University Hospitals and Maadi Military Hospital, Egypt between 2013 and 2016. The sample size was 40 patients divided into two groups; 20 patients for laparoscopic arm and 20 patients for the open trans-abdominal surgery. Inclusion criteria: histopathology confirmed rectal cancer, patients fit for operative resection, and with T1- T3 grades according to the preoperative evaluation. The exclusion criteria: Patients with T4 stage tumor, patients present as emergency cases and patients present with recurrence of the tumor and synchronous colonic tumors. Results The circumferential resection margins (CRM) of the mesorectum when examined pathologically after resection showed no difference between the two arms of the study with laparoscopic group specimens 3.18±1.16 mm mean, (SD) compared to 3.50±0.45 mm mean, (SD) in the open surgery group with no statistically significant difference. The longitudinal resection margins (LRM) was (5.50±1.98 mean, SD) in the laparoscopic group compared to (5.20±2.28 mean, SD) in the open conventional surgery group with no significant difference found between the two groups. Total operative time was significantly shorter in the trans-abdominal surgery group, while the hospital stay period was significantly shorter in the laparoscopy group. Laparoscopy group also showed significantly time before flatus passage, and the patients in the laparoscopy group started oral intake faster than open surgery group. Conclusion In our study, the radicality of the rectal cancer excision in both laparoscopic and traditional open surgery, showed non inferiority of the laparoscopic technique over open surgery Long-term clinical outcomes of overall survival and recurrence is the foremost parameters which should be taken in consideration for decision for laparoscopic surgery for rectal cancer. Additional follow-up results from the current trial are presently being developed, beside with records on other secondary end points, like cost effectiveness and quality of life.

Comparison of Laparoscopic and Open Surgery for Patients With Borderline Ovarian Tumors

2018 ◽  
Vol 28 (9) ◽  
pp. 1657-1663 ◽  
Author(s):  
Hee-Jung Jung ◽  
Jeong-Yeol Park ◽  
Dae-Yeon Kim ◽  
Dae-Shik Suh ◽  
Jong-Hyeok Kim ◽  
...  
Keyword(s):  
Overall Survival ◽  
Laparoscopic Surgery ◽  
Surgical Outcomes ◽  
Open Surgery ◽  
Disease Free Survival ◽  
Free Survival ◽  
Borderline Ovarian Tumors ◽  
Surgery Group ◽  
Significant Difference ◽  
Disease Free

ObjectivesThe aim of this study was to compare surgical and oncologic outcomes of open and laparoscopic surgery in patients with borderline ovarian tumors (BOTs).Materials and MethodsThis study included patients with BOTs who underwent open (n = 433) or laparoscopic (n = 210) surgery between 1990 and 2015. Surgical outcomes, perioperative morbidity, and disease-free survival and overall survival were compared.ResultsThere was no significant difference in age, histologic type of tumor, and laterality of tumor. However, body mass index was slightly higher for the open surgery group (P = 0.046). The open surgery group had a higher serum cancer antigen 125 level (P < 0.001), larger tumor size (P < 0.001), more frequent radical surgery (P = 0.001), higher stage (P = 0.034), and higher incidence of invasive implants (P = 0.035). The operative time (P < 0.001), time interval to return of bowel movement (P < 0.001), and length of postoperative hospital stay (P < 0.001) were significantly shorter and estimated blood loss was significantly less (P < 0.001) in the laparoscopic group. Perioperative complications were documented in 5 (2.4%) patients in the laparoscopic surgery group and 17 (3.9%) in the open surgery group (P = 0.064). Twenty-three (5.3%) patients in the open surgery group and 9 (4.3%) in the laparoscopic surgery group had recurrence (P = 0.902) at a median follow-up of 57 months. The 10-year disease-free survival was 96% and 97% for the open and laparoscopic groups, respectively (P = 0.851), with no significant difference between the groups after adjusting for independent factors (odds ratio, 1.0; 95% confidence interval, 0.4–2.4; P = 0.999). The 10-year overall survival was 99% for both groups, respectively (P = 0.441).ConclusionsLaparoscopic surgery and open surgery showed similar survival outcomes in BOTs. The surgical outcomes of laparoscopic surgery were more favorable.

scholarly journals Retrospective Study on Safety and Efficacy of Transperitoneal Laparoscopic Surgery and Open Surgery for Retrocaval Ureter

2021 ◽  
Author(s):  
Dilip Kumar Pal ◽  
Ashutosh Kumar Tiwari ◽  
Krishnendu Maiti
Keyword(s):  
Laparoscopic Surgery ◽  
Open Surgery ◽  
Definitive Treatment ◽  
Invasive Technique ◽  
P Value ◽  
Safety And Efficacy ◽  
Retrocaval Ureter ◽  
Surgery Group ◽  
Estimated Blood Loss ◽  
Significant Difference

Introduction: Retrocaval ureter is a rare congenital anomaly which remains silent until the 3rd or 4th decade of life. But once a patient develops symptoms, it mandates treatment in the form of surgical management. Open surgery has traditionally been considered as the standard of care but it has its own downside or limitations. It requires a relatively large skin incision causing significant postoperative pain and thus prolonging convalescence. Transperitoneal laparoscopic approach is the preferred approach by most surgeons owing to large working space and familiar anatomy. Aim: To compare the safety and efficacy of transperitoneal laparoscopic and open surgery for definitive management of retrocaval ureter. Materials and Methods: Clinical data of fifteen patients, that underwent surgery for retrocaval ureter from December 2013 to January 2020 and the study of this data was done from June 2020, at Urology Department were analysed retrospectively. Out of 15 patients, seven were treated by open surgery while eight underwent transperitoneal laparoscopic surgery. Ureter was transpositioned to normal anatomic position followed by uretero-ureterostomy. Student t-test was applied to interpret and analyse the data obtained in both the groups using SPSS version 24. Results: Total of 15 patients data was studied (7 open surgery + 8 transpertional laparoscopic surgery, age 21-45 years). Intraoperative and postoperative data were compared between the transperitoneal laparoscopic and open surgery group. A statistically significant difference was found for operative time (p-value <0.001), estimated blood loss (p-value <0.05), analgesic requirement (p-value <0.001), drain removal (p-value <0.05) and hospital stay (p-value <0.001) between the two groups. Superficial surgical site infection was noted in two patients in open surgery group. For rest 13 patients postoperative period was uneventful. The follow-up of all patients was done for 12-36 months. Conclusion: Transperitoneal laparoscopic uretero-ureterostomy as a definitive treatment of retrocaval ureter is safe, effective and reliable option with less trauma and faster recovery. This minimally invasive technique can be considered as the first choice for treatment of retrocaval ureter on account of familiar anatomy and easier learning curve in contrast to retroperitoneal laparoscopic or robotic surgery.

scholarly journals Clinical effect of minimally invasive surgery for inguinal cryptorchidism

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yunjin Wang ◽  
Liu Chen ◽  
Xu Cui ◽  
Chaoming Zhou ◽  
Qing Zhou ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Laparoscopic Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Clinical Effect ◽  
Testicular Atrophy ◽  
Surgery Group ◽  
Significant Difference ◽  
Good Cosmetic ◽  
Scrotal Hematoma

Abstract Background The purpose of this study was to investigate the clinical effect of minimally invasive surgery for inguinal cryptorchidism. Methods The patients were divided into the minimally invasive surgery group (n = 100) and the traditional surgery group (n = 58). In the minimally invasive surgery group, patients with low inguinal cryptorchidism (n = 54) underwent surgery with a transscrotal incision, and patients with high inguinal cryptorchidism (n = 46) underwent laparoscopic surgery. Results There was no difference in the hospital stay duration or cost between the minimally invasive surgery group and the traditional surgery group (P > 0.05). As for the operative time, minimally invasive surgery of low inguinal cryptorchidism was shorter than traditional surgery (P = 0.033), while minimally invasive surgery of high inguinal cryptorchidism was comparable to traditional surgery (P = 0.658). Additionally, there were no cases of testicular atrophy, testicular retraction, inguinal hernia or hydrocele in either group. There was no significant difference in the incidence of poor wound healing between the two groups (P > 0.05). Although there was no significant difference in the incidence of scrotal hematoma between the two groups (P > 0.05), the incidence in the minimally invasive surgery group was higher than that in the traditional surgery group. Conclusions Minimally invasive surgery including a transscrotal incision for low inguinal cryptorchidism and laparoscopic surgery for high inguinal cryptorchidism is as safe and effective as traditional surgery, and could also provide a good cosmetic effect for children.

scholarly journals Minimally Invasive Video-assisted Thyroidectomy vs Conventional Open Hemithyroidectomy in Asian Patients

2016 ◽  
Vol 8 (3) ◽  
pp. 189-192
Author(s):  
Reyaz M Singaporewalla ◽  
Anil D Rao ◽  
Arunesh Majumder
Keyword(s):  
Postoperative Pain ◽  
Minimally Invasive ◽  
Pain Score ◽  
Open Surgery ◽  
Operating Time ◽  
Incision Length ◽  
Video Assisted ◽  
Asian Patients ◽  
Significant Difference ◽  
Conventional Open Surgery

ABSTRACT Introduction Although the technique of minimally invasive video assisted thyroidectomy (MIVAT) is well established in continental Europe, data on it's role in Asian patients is limited. We compared the results of MIVAT with conventional open hemithyroidectomy in Asian patients. Materials and methods Over a 1-year period, patients undergoing hemithyroidectomy for benign symptomatic goiters were selected. Inclusion criteria for MIVAT were benign colloid goiters, recurrent cysts or follicular lesions and neoplasms with lobe volume of less than 40 cc or nodule diameter less than 35 mm. Larger goiters underwent conventional open surgery. Patients with previous neck surgery and proven malignancy were excluded. Operative time, complications, postoperative pain score, incision length and cosmetic satisfaction at 6 months were recorded. Results Thirty-six patients (MIVAT-21, Conventional-15) were included. Both groups were comparable in terms of demographic profile and co-morbidities. The mean operating time for both groups showed no significant difference (MIVAT = 111.67 ± 19.4 min, Conventional = 112.40 ± 25.06 min; p = 0.925). Minimally invasive video assisted thyroidectomy patients had significantly less pain in the immediate postoperative period (mean pain score 2.38 vs 4.8, p < 0.001). Mean incision length at end of surgery was significantly smaller in the MIVAT group (2.58 vs 6.3 cm; p < 0.001). Neck scar satisfaction at 6 months was excellent in 71.4% of MIVAT cases vs 26.6% of conventional hemithyroidectomy cases. There were no complications in any of the treatment groups. Conclusion In selected cases, MIVAT is as safe as conventional open surgery with distinct advantages of better postoperative pain control and cosmesis. How to cite this article Rao AD, Singaporewalla RM, Majumder A. Minimally Invasive Video-assisted Thyroidectomy vs Conventional Open Hemithyroidectomy in Asian Patients. World J Endoc Surg 2016;8(3):189-192.

scholarly journals Nonsurgical Management of Acute Uncomplicated Appendicitis in Children: the Analysis of Treatment Outcome in Relationship with Antimicrobial Regimens and Adverse Prognostic Factors

2016 ◽  
Vol 16 (2) ◽  
pp. 12-16
Author(s):  
Elina Silina ◽  
Asnate Jurgele ◽  
Arturs Viksne ◽  
Zane Abola ◽  
Arnis Engelis ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Surgical Treatment ◽  
Acute Appendicitis ◽  
Clinical Signs ◽  
Drug Combinations ◽  
Antimicrobial Drug ◽  
Nonsurgical Management ◽  
Unsuccessful Treatment ◽  
Significant Difference ◽  
Non Surgical Treatment

SummaryIntroduction.For acute appendicitis - the most frequent condition to perform an urgent abdominal operation in pediatric surgery - surgical appendectomy still remains the gold standard regarding treatment, nevertheless nonsurgical management has become more and more recognized as a treatment method for uncomplicated acute appendicitis (UAA). However there are still many unanswered questions regarding possible factors that could predict the treatment outcome as well as appropriate antimicrobial drug regimens.Aim of the Study.The aim was to investigate if there is a possible association between factors such as C-reactive protein (CRP) level, presence of appendicolith, the diameter of the appendix and treatment outcome; as well as to identify most successfully used antimicrobial drug combinations.Material and methods.A retrospective analysis of hospital cases, admitted to a single reference center during the time period from 2013 to 2015. Patients with clinical signs of acute appendicitis, elevated inflammatory markers and radiological findings suggestive for acute appendicitis were included in the study. Nonsurgical treated patients were divided in two groups based on the treatment outcome - successful or unsuccessful. Analysis of the three factors (CRP level, presence of appendicolith and the diameter of the appendix) and most commonly used antimicrobial drug regimen association with treatment outcome was performed.Results.Overall 384 children medical records with acute appendicitis were registered and non-surgical treatment was initiated in 147/384 (38 %) cases. Successful treatment outcome of nonsurgical management was identified in 114/147 (78 %) cases. Analyzing prognostic adverse factors results presents no statistically significant difference in association with CRP level >25 mg/l (p=0,479), presence of appendicolith (p=0,183) and the diameter of appendix >1 cm (p=0,183) with successful or unsuccessful treatment outcome. The two most commonly used antimicrobial drug combinations were - Ampicillin/Metronidazole for 49 patients and Ampicillin/Gentamicin for 44 patients. No relevance with treatment outcome and used antimicrobial agents was detected (p=0,597).The overall recurrence rate after initial presentation is 15 % (17/114). In 3 cases (3 %) recurrent appendicitis developed one month after discharge and in 14 cases (12 %) up to one year after discharge.Conclusions.Prognostic adverse factors - CRP, presence of appendicolith and diameter of appendix - were not statistically reliable in association with initial non-surgical treatment outcome. The success rate of conservative treatment with narrow spectrum antibiotics was 78 %, which is just as high as in cases treated conservatively with broad-spectrum antibiotics from previous studies. Therefore the question of which factors and antimicrobial drug combinations influence the course of treatment still remains unanswered and further studies are required.

scholarly journals Application of platysma muscle suture after thyroidectomy

2020 ◽  
pp. 147-150
Keyword(s):  
Postoperative Pain ◽  
Wound Infection ◽  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Platysma Muscle ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
The Mean ◽  
Length Of Hospitalization

Introduction: Thyroidectomy is a common surgery in the neck area, in which the application of platysma muscle suture after thyroidectomy is still being discussed. This study was conducted to compare the application (currently common) or non-application of suture for platysma muscle. Methods: In this retrospective cross-sectional study, 117 patients underwent thyroidectomy, among which 63 cases without suturing platysma (control group) and 54 subjects with suturing platysma (Intervention group ) were examined in terms of postoperative pain based on visual analogue scale score measured 24 h post-operation. The samples were also investigated regarding hematoma and seroma, wound infection, length of hospitalization, scarring (1 year after surgery), duration of surgery, and the number of cases using opioids during the hospitalization. Patients with diabetes, previous neck surgery, coagulopathy, and radiation history were excluded from the study. The gathered data were analyzed statistically in SPSS software (version 18) using the Chi-square test and the Mann–Whitney U test. A p-value of less than (0.05) was considered significant. Results: Based on the findings, the mean age of the patients in the Intervention group was calculated at 51 years, of which 41 and 13 cases were females and males, respectively. In the Intervention group, 34 patients underwent complete thyroidectomy and 20 patients had hemithyroidectomy. The mean age score of subjects in the control group was calculated at 50 years, of which 44 and 19 patients were respectively female and male. No significant difference was revealed considering wound infection, length of hospitalization, created scarring, the amount of opioid use (opioids), and postoperative pain. However, only the length of surgery was different between the groups (P-value<0.05). Conclusions: There was no difference between wound and surgical complications and cosmetic results between both groups; nevertheless, due to the duration of the surgery and other benefits, such as consuming less thread, not suturing the platysma is recommended.

scholarly journals Clinical effect of minimally invasive surgery for inguinal cryptorchidism

2020 ◽  
Author(s):  
Yunjin Wang ◽  
Liu Chen ◽  
Xu Cui ◽  
Chaoming Zhou ◽  
Qing Zhou ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Laparoscopic Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Clinical Effect ◽  
Testicular Atrophy ◽  
Surgery Group ◽  
Significant Difference ◽  
Good Cosmetic ◽  
Scrotal Hematoma

Abstract Background: The purpose of this study was to investigate the clinical effect of minimally invasive surgery for inguinal cryptorchidism.Methods: The patients were divided into the minimally invasive surgery group (n=100) and the traditional surgery group (n=58). In the minimally invasive surgery group, patients with low inguinal cryptorchidism (n=54) underwent surgery with a transscrotal incision, and patients with high inguinal cryptorchidism (n=46) underwent laparoscopic surgery. Results: There was no difference in the hospital stay duration or cost between the minimally invasive surgery group and the traditional surgery group (P>0.05). As for the operative time, minimally invasive surgery of low inguinal cryptorchidism was shorter than traditional surgery (P=0.033), while minimally invasive surgery of high inguinal cryptorchidism was comparable to traditional surgery (P=0.658). Additionally, there were no cases of testicular atrophy, testicular retraction, inguinal hernia or hydrocele in either group. There was no significant difference in the incidence of poor wound healing between the two groups (P>0.05). Although there was no significant difference in the incidence of scrotal hematoma between the two groups (P>0.05), the incidence in the minimally invasive surgery group was higher than that in the traditional surgery group. Conclusions: Minimally invasive surgery including a transscrotal incision for low inguinal cryptorchidism and laparoscopic surgery for high inguinal cryptorchidism is as safe and effective as traditional surgery, and could also provide a good cosmetic effect for children.

scholarly journals Laparoscopic Urological Surgery: Our Initial Experiences

2020 ◽  
Vol 23 (1) ◽  
pp. 17-23
Author(s):  
Shiba Prasad Nandy ◽  
AKM Akramul Bari ◽  
Anirban Ghose ◽  
Hasmot Ali Mia ◽  
Md Alamgir ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Hospital Stay ◽  
Radical Nephrectomy ◽  
Open Surgery ◽  
Renal Cyst ◽  
Conversion To Open Surgery ◽  
Cyst Excision ◽  
Excellent Outcome ◽  
Duration Of Surgery ◽  
The Mean

Introduction and Objective: Laparoscopic surgery is increasingly exercised in urology due to improvements in technical capabilities and experience. It comes with many advantages compared to open surgery such as lesser degree of pain and haemorrhage, shorter hospital stay and better cosmetic results. This study is carried out to evaluate the outcomes and complications of urological laparoscopic surgery cases performed Chittagong Medical College Hospital, Chattogram, Bangladesh. Methods: This was a hospital based prospective observational study of total 29 patients, who received laparoscopic surgery of different kinds between January 2017 and September 2019 for urological causes with a minimum one month follow-up. Included patients were assessed in terms of demographic characteristics, preoperative diagnosis, type of laparoscopic approach, duration of surgery and hospitalization, complications after surgery and need for conversion to open surgery. Results: The mean age was 45.03 years where 12 patients were women and 17 were male. All patients underwent trans-peritoneal procedures where2 patients received renal cyst excision, 4 simple nephrectomy, 5 ureterolithotomy, 9 radical nephrectomy, 1 radical cystectomy, 2 adrenalectomy, 3 pyelolithotomy and 3 pyeloplasty. Three of the 29 patients required conversion to open surgery. Except these patients, no major complication or mortality was encountered. The mean duration of surgery for the most commonly applied procedures were as follows: renal cyst excision 87.5 (70-105) min, simple nephrectomy 141.25 (120-170) min, ureterolithotomy 120 (100-140) min, radical nephrectomy 215.56 (180-260) min, pyelolithotomy 120 (100-140) min, and pyeloplasty 156.67 (130-190) min. The mean hospital stay was 4.59±1.7 (2-8) days. Conclusions: The success and complications rate of the laparoscopic urological surgeries performed in our hospital were consistent with those reported in the literature. In the light of technological advances and increasing experience, we believe that laparoscopic surgery is an effective technique with excellent outcome along with a safe and feasible alternative to open surgery in the field of urology. Bangladesh Journal of Urology, Vol. 23, No. 1, January 2020 p.17-23

scholarly journals A comparative study of short term results of open haemorrhoidectomy and stapler haemorrhoidopexy

2017 ◽  
Vol 4 (10) ◽  
pp. 3358
Author(s):  
Chandrasekhar S. Neeralagi ◽  
Yogesh Kumar ◽  
Surag K. R. ◽  
Lakkanna Suggaiah ◽  
Preetham Raj
Keyword(s):  
Surgical Treatment ◽  
Postoperative Pain ◽  
Return To Work ◽  
Hospital Stay ◽  
Stapled Hemorrhoidopexy ◽  
Short Term ◽  
Post Operative Pain ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
Post Operative Complications

Background: Haemorrhoids are the most common benign anorectal problems worldwide. Treatments of third and fourth degree hemorrhoids include surgical haemorrhoidectomy. Milligan Morgan haemorrhoidectomy (MMH) as described in 1937 has remained the most popular among many techniques proposed. In order to avoid the postoperative drawbacks of Milligan Morgan haemorrhoidectomy, a new surgical treatment for prolapsing haemorrhoids has been described by Longo in 1995, procedure called stapled haemorrhoidopexy which is associated with less postoperative pain and a quicker recovery. The objective of this study was to compare the short-term outcome between stapled hemorrhoidopexy and Milligan-Morgan hemorrhoidectomy.Methods: Prospective randomized study of 120 patients with grade 3 and grade 4 haemorrhoids requiring surgical treatment either MMH or SH, 60 in each group for the period of 18 months from June 2014 to November 2015. Post-operative pain, duration of surgery, duration of hospital stays, post-operative complications and time taken to return to work were compared with mean follow up period of 6 months.Results: Duration of surgery is significantly low in stapled group with P <0.001, duration of hospital stay is significantly low in stapled group with P <0.001, post-operative pain low in staple group with P <0.05, time taken to return to work is significantly early in stapled group with P <0.001. Post-operative complications incontinence not found in the present study but recurrence of two cases in each group noted.Conclusion: Stapled hemorrhoidopexy is associated with less postoperative pain, shorter duration of surgery and hospital stay, earlier return to work as compared with Milligan-Morgan open hemorrhoidectomy. The procedure is not associated with major post-operative complications.

Sign in / Sign up

Export Citation Format

Share Document