Publication Date: 2024/02/02
Abstract: Background: Milligan-Morgan (open) and Ferguson (closed) hemorrhoidectomies are effective treatments for severe haemorrhoids, but debate lingers about post-operative complications. Studies differ on which approach leads to less pain, anal incontinence, bleeding, or healing issues. This research at University of Abuja Teaching Hospital (UATH) aimed to compare these methods of treatment of severe haemorrhoids to undertake appropriate pre- operative counselling and patient decisions. Objective: To compare the severity of post-operative pain at the time of the first bowel movement and anal incontinence at the sixth week following surgery to better understand patients' experiences with open versus closed haemorrhoidectomy. Patients and Method: Thirty-six (36) patients (26-72 years, both sexes) with severe haemorrhoids were randomly assigned to either open (Group A) or closed (Group B) surgery at UATH. Both groups received spinal anaesthesia. Pain was assessed using a visual scale (score 0-10) at various intervals until 6 weeks after surgery, including during the first bowel movement. Patients were trained on using the scale, with higher scores indicating worse pain. The secondary outcome of anal incontinence was measured at 6 weeks with questionnaires and clinical examination. IBM SPSS 27 was utilized for the data analysis (p < 0.05 for significance). Result: Both the open and closed haemorrhoidectomy methods provide similar levels of pain. There was no statistically significant variation in the level of discomfort experienced during the two hemorrhoidectomies methods. Due to the lack of a statistically significant difference, the complications associated with anal incontinence were similar in both groups. Conclusion: Both open and closed haemorrhoidectomy offer manageable pain, with no statistically significant difference in pain intensity in both groups. There is no statistical difference in anal incontinence in the open and closed techniques of haemorrhoidectomy.
Keywords: Post-Operative Pain, Haemorrhoid, Haemorrhoidectomy, Complications, Comparison.
DOI: https://doi.org/10.5281/zenodo.10610019
PDF: https://ijirst.demo4.arinfotech.co/assets/upload/files/IJISRT24JAN1220.pdf
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