BioMedica |

Original Article

VOLUME: 36 | ISSUE: 2 | Jun 30, 2020 | PAGE: (132 - 137) | DOI: 10.24911/BioMedica/5-126

Role of Internal Sphincterotomy as an Adjunct to Open Haemorrhoidectomy for Management of Third- and Fourth Degree Haemorrhoids

Authors: Waseem Sadiq Awan , Arslan Ahmed , Raza Farrukh , Yar Muhammad , Salman Athar , Hafiz Muhammad Sajid Jehangir , Ghulam Mustafa Arain

Article Info

Authors

Waseem Sadiq Awan

Ex Associate Professor Sargodha Medical College, Sargodha-Pakistan.

Arslan Ahmed

Epidemiologist

Raza Farrukh

Assistant Professor Sargodha Medical College, Sargodha – Pakistan.

Yar Muhammad

Professor King Edward Medical University (KEMU), Lahore – Pakistan.

Salman Athar

Assistant Professor Gujranwala Medical College, Gujranwala – Pakistan.

Hafiz Muhammad Sajid Jehangir

Assistant Professor King Edward Medical University (KEMU), Lahore – Pakistan.

Ghulam Mustafa Arain

Dean College of Physicians and Surgeons (CPSP), Lahore – Pakistan.

Publication History

Received: March 08, 2020

Revised: May 02, 2020

Accepted: June 15, 2020

Published: June 30, 2020

Abstract

Background and Objective: Post-operative pain and complications are common after open haemorrhoidectomy. Addition of internal sphincterotomy has shown to improve the post-operative outcomes. This study is conducted to compare the outcomes of open haemorrhoidectomy with and without internal sphincterotomy.
Methods: A prospective randomized controlled trial was conducted in the Department of Surgery at Sargodha Medical College/District Headquarter Hospital, Sargodha from February 2016 to December 2017. One hundred and twenty-two patients presenting with third and fourth degree haemorrhoids were divided in two equal groups. In group “A”, haemorrhoidectomy with internal sphincterotomy and in group “B”, haemorrhoidectomy alone was performed. Outcome variables such as pain scores based on Verbal Rating Scales (VRS), hospital stay, complications and wound healing were compared in both groups.
Results: The mean pain scores were less in the internal sphincterotomy group A i.e., 3.3 ± 0.3 while it was 3.6 ± 0.4 in group B at 1st post-op day. The mean duration of hospital stay was less in group A (2.3 ± 0.7 days) and it was 3.4 ± 0.9 days in group B. On the 7th post-operative day, 13 (21.3%) patients in group A and 4 (6.6%) patients in group B had flatus incontinence. Urinary retention was present in 4 (6.6%) cases in group A and 13 (21.3%) in group B. Post-operative bleeding was present in 44 (72.1%) cases of group A and 41 (67.2%) of group B. Constipation was higher in the group B (44.3% vs. 37.7%). Wound healing was better in group A (63.3%). Anal stenosis occurred in 3 (4.9%) patients who were treated with
haemorrhoidectomy alone.
Conclusion: Addition of internal sphincterotomy improves the outcome of open haemorrhoidectomy in patients of third- and fourth-degree haemorrhoids. It is therefore recommended to carryout internal sphincterotomy when operating on such patients

Keywords: Haemorrhoids, Haemorrhoidectomy, Lateral internal sphincterotomy, Postoperative complications.

Pubmed Style

Waseem Sadiq Awan, Arslan Ahmed, Raza Farrukh, Yar Muhammad, Salman Athar, Hafiz Muhammad Sajid Jehangir, Ghulam Mustafa Arain. Role of Internal Sphincterotomy as an Adjunct to Open Haemorrhoidectomy for Management of Third- and Fourth Degree Haemorrhoids. BioMedica. 2020; 30 (June 2020): 132-137. doi:10.24911/BioMedica/5-126

Web Style

Waseem Sadiq Awan, Arslan Ahmed, Raza Farrukh, Yar Muhammad, Salman Athar, Hafiz Muhammad Sajid Jehangir, Ghulam Mustafa Arain. Role of Internal Sphincterotomy as an Adjunct to Open Haemorrhoidectomy for Management of Third- and Fourth Degree Haemorrhoids. https://biomedicapk.com/articles/online_first/126 [Access: May 07, 2024]. doi:10.24911/BioMedica/5-126

AMA (American Medical Association) Style

Vancouver/ICMJE Style

Waseem Sadiq Awan, Arslan Ahmed, Raza Farrukh, Yar Muhammad, Salman Athar, Hafiz Muhammad Sajid Jehangir, Ghulam Mustafa Arain. Role of Internal Sphincterotomy as an Adjunct to Open Haemorrhoidectomy for Management of Third- and Fourth Degree Haemorrhoids. BioMedica. (2020), [cited May 07, 2024]; 30 (June 2020): 132-137. doi:10.24911/BioMedica/5-126

Harvard Style

Waseem Sadiq Awan, Arslan Ahmed, Raza Farrukh, Yar Muhammad, Salman Athar, Hafiz Muhammad Sajid Jehangir, Ghulam Mustafa Arain (2020) Role of Internal Sphincterotomy as an Adjunct to Open Haemorrhoidectomy for Management of Third- and Fourth Degree Haemorrhoids. BioMedica, 30 (June 2020): 132-137. doi:10.24911/BioMedica/5-126

Chicago Style

Waseem Sadiq Awan, Arslan Ahmed, Raza Farrukh, Yar Muhammad, Salman Athar, Hafiz Muhammad Sajid Jehangir, Ghulam Mustafa Arain. "Role of Internal Sphincterotomy as an Adjunct to Open Haemorrhoidectomy for Management of Third- and Fourth Degree Haemorrhoids." 30 (2020), 132-137. doi:10.24911/BioMedica/5-126

MLA (The Modern Language Association) Style

APA (American Psychological Association) Style

Waseem Sadiq Awan, Arslan Ahmed, Raza Farrukh, Yar Muhammad, Salman Athar, Hafiz Muhammad Sajid Jehangir, Ghulam Mustafa Arain (2020) Role of Internal Sphincterotomy as an Adjunct to Open Haemorrhoidectomy for Management of Third- and Fourth Degree Haemorrhoids. , 30 (June 2020), 132-137. doi:10.24911/BioMedica/5-126