Publication:

Open haemorrhoidectomy revisited: the study of 25 cases

Background Haemorrhoids continue to be the commonest benign anorectal condition presenting with bleeding and constipation. The presentation may vary depending on the grade of haemorrhoids. Deciding the best therapeutic option is the biggest challenge faced by the attending surgeon in an era where newer therapeutic technologies for treatment continue to evolve. Therefore, revisiting the traditional surgical option of excision and ligation technique for grossly symptomatic piles was evaluated taking into consideration the cost of the procedure. Twenty five consecutive patients of symptomatic grade III and IV haemorrhoids were selected for the study to determine the outcome of the traditional open method (Milligan Morgan technique)

Methods Twenty five patients after having been checked for fitness for anaesthesia underwent the open method of haemorrhoidectomy under spinal anaesthesia. On admission to hospital a detailed proforma which contained demographic details, and comorbidities was completed. All 25 patients underwent the same procedure by ligation excision technique. Details of operative findings including post-operative outcomes were studied prospectively. Results were evaluated.

Results Of the 25 patients, one patient developed bleeding in the immediate post-operative period which required relook surgery and undermining of the oozing stump. Four patients required catheterisation for urinary retention. A six month follow up did not reveal recurrence or any sort of discomfort while passing stools.

Conclusions Open haemorrhoidectomy (Milligan Morgan) continues to be the most optimum method for treatment of symptomatic piles grade III and IV.