Comparative study between stapled and open hemorrhoidectomy results with one-year follow-up

Abstract

Background Hemorrhoids are one of the most prevalent diseases of mankind, affecting 4%–36% of the general population. Most patients are asymptomatic. Anal bleeding during the act of defecation is the most common presenting symptom. Many techniques were described for treatment, including stapled hemorrhoidectomy and conventional (open) ones. Objective The objective is to compare the effectiveness, short-term outcomes, and postoperative complications of stapled hemorrhoidopexy against open hemorrhoidectomy in the treatment of symptomatic primary piles. Methods A total of 76 patients were operated on at Al-Azhar University Hospital. They were divided into two equal groups: the stapled group (operated using a proximate PPH hemorrhoidal stapler of 33 mm) and the open group. All patients were followed for 1 year. Preoperative complaints, operative time and blood loss, postoperative pain, complications, and resumption of daily activities were recorded for both groups. Results Intraoperative blood loss and duration of operation were less in the stapler group. Postoperative bleeding, postoperative pain, and discomfort were less in the stapler group, with a significant difference from the open group. Healing and resumption of daily activities were faster in the stapler group. Regarding early recurrence, it happened in two cases in the stapler group and in the open group as well. There are no differences between both groups regarding urine retention. Anal incontinence did not happen in both groups. Mild anal stenosis occurred in one case in every group and occurred late. Conclusion Stapled hemorrhoidectomy is a promising procedure with less pain, a shorter duration of hospital stay, and a faster resumption of daily activity than open hemorrhoidectomy. However, long-term follow-up for many years is still needed to define the recurrence rate in stapled hemorrhoidectomy.