A study of band ligation versus hemorhoidectomy for the treatment of Grade III hemorhoids at tertiary health care centre
Journal Title: Medpulse International Journal of Surgery - Year 2018, Vol 8, Issue 1
Abstract
Background: Hemorrhoids are among the commonest surgical ailments of anorectal region seen in the outpatient department. Aims and Objectives: A comparative study of band ligation versus hemorhoidectomy for the treatment of Grade III hemorhoids at tertiary health care centre. Methodology: This was cross sectional on the 70 patients of Diagnosed of Grade III hemorrhoids during May 2017 to May 2018 was carried out at the Department of Surgery of a tertiary care hospital, written consent of the patients regarding benefits and side-effects of both the treatment methods was explained, and those who don’t give consent, having serious associated illness,deranged coagulation profile were excluded from the study. All eligible Grade III hemorrhoids patients were given treatment by Milligon –Morgan Haemorrhoidectomy was performed by the Standard method described in Literature 1this constituted treatment Group B. and Rubber Band ligation in Group A. The eligible patients for the surgeries were randomly allocated to the Group A (35 patients) and Group B (35 patients) by computer generated random numbers. The statistical analysis done by Un-paired t-test by SPSS 19 version software. Result : In our study we have seen that The difference in two groups of the average age is comparable (P>0.05;t=1.82;df=68.); Operative time was significantly lower in Group A compared to Group B(P<0.0001 ;t = 11.45; df=38.) ; Intra-operative bleeding was significantly lower in Group A compared to Group B (P< 0.0001 ; t = 47.82 df=68 ); Time to first bowel movement (hr) was significantly lower in Group A compared to Group B (P<0.0001; t = 15.87 df=68 ); Average hospital stay (Days) was significantly lower in Group A compared to Group B (P<0.0001; t = 9.24 df=68); Average Analgesic required (No. of Tab.) was significantly lower in Group A compared to Group B (P<0.0001;t=17.82 df=68). Time required for Wound healing was significantly lower in Group A compared to Group B (P<0.0001;t=19.82 df=68). Overall the complications were, more in the Group B (51.42 %) (Milligan Morgan Haemorrhoidectomy) as compared to Group A (10%) (band ligation). The complications like Urinary retention, Bleeding, Incontinence of flatus, External tags, Recurrence, Anal stenosis, were common in Group B than Group A. Conclusion: Overall the operative outcomes like less intra-operative bleeding, less time for the first bowel movement with less analgesic were better in Rubber band ligation and overall complications were less in Radiofrequency Ablation compared to conventional Milligan Morgan Haemorrhoidectomy.
Authors and Affiliations
Ramu Kamatala, Sudagani Sreenivas
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