A Comparative Study to Compare the incidence of Post-Operative Pain in Patients Undergoing Haemorrhoidectomy with Lateral Sphincterotomy Vs. Haemorrhoidectomy without Lateral Sphincterotomy
Background: Haemorrhoids are common pathology of anal canal. Over the last few years, because of new surgical techniques, increased attention has been laid on Surgical Management of hemorrhoids, still open Haemorrhoidectomy remains the mainstay of treatment. Postoperative pain is one of the most common complications of open Haemorrhoidectomy. In our study we decided to compare the incidence of postoperative pain in open Haemorrhoidectomy with or without lateral sphincterotomy.
Methods: To compare the incidence of post-operative pain in patient of open Haemorrhoidectomy with lateral sphincterotomy versus open Haemorrhoidectomy without lateral sphincterotomy. Results: In our study group A in which open Haemorrhoidectomy along with lateral sphincterotomy was done had statistically significant less postoperative pain at 6 hours and 24 hours postoperatively and on postoperative day 7 at the time of follow up with Chi square test (P<0.0001).
Conclusion: Addition of lateral sphincterotomy decreased post-operative pain and also reduced the need for post-operative analgesia in a significant number of patients. Hence through this study, we concluded that in conventional open Haemorrhoidectomy, addition of lateral sphincterotomy is an effective, convenient, and simple way to reduce post-operative pain.
2. Buie LA. Practical Proctology. Vol. 2. Springfield: Charles C Thomas; 1960. p. 737-40.
3. Mathai V, Ong BC, Ho YH. Randomized controlled trial of lateral internal sphincterotomy with haemorrhoidectomy. Br J Surg 1996;83:380-2.
4. Kanellos I, Zacharakis E, Christoforidis E, Angelopoulos S, Kanellos D,
Pramateftakis MG, et al. Usefulness of lateral internal sphincterotomy in reducing postoperative pain after open hemorrhoidectomy. World J Surg 2005;29:464-8
5. Allen-Mersh TG, Mann CV. Open haemorrhoidectomy (ST Mark's ligation/excision method). In: Fielding LP, editor. Operative Surgery. Surgery of the Colon, Rectum & Anus. 5 th ed. London: Butterworth Heinemann Ltd.; 1993. p. 789-96
6. Khubchandani IT. Internal sphincterotomy with hemorrhoidectomy does not relieve pain: A prospective, randomized study. Dis Colon Rectum 2002;45:1452-7.
7. Kanellos I, Zacharakis E, Christoforidis E, Angelopoulos S, Kanellos D, Pramateftakis MG, et al. Usefulness of lateral internal sphincterotomy in reducing postoperative pain after open Haemorrhoidectomy. World J Surg 2005;29:464-8.
8. Ascanelli S, Gregorio C, Tonini G, Baccarini M. Long stapled Haemorrhoidectomy versus Milligan-Morgan procedure. ChirItal 2005;57(4):439-47.
9. Galizia G, Lieto E, Castellano P, Pelosio L, Imperatore V and Pignatelli C. Lateral internal sphincterotomy together with Haemorrhoidectomy for treatment of haemorrhoids: a randomized prospective study. European Journal of Surgery, 2000;166:223-8.
10. Diana G, Guercio G, Cudia B. Internal sphincterotomy reduces postoperative pain after Millligan Morgan Haemorrhoidectomy. BMC Surg;2009:10:09-16.
11. Chauhan A, Thomas S, Bishnoi PK. Randomized controlled trial to assess the role of raised anal pressure in the pathogenesis of symptomatic early haemorrhoids. Dig Surg.2007;24:28-32