Outcome of stapled haemorrhoidectomy as a day care procedure
Asim Rafiq Laharwal, Arshad Rashid, Ajaz Ahmad Wani
Background: Haemorrhoids are amongst the most common anal disorders. There are numerous surgical options in managing haemorrhoids. However, owing to its many advantages like decreased post-operative pain, stapled haemorrhoidectomy has gained a considerable popularity. Objective: To study the feasibility of stapled haemorrhoidectomy as a day care procedure in the management of haemorrhoidal disease. Methods: This study was conducted over a period of 4 years, from May 2015 to June 2019 on patients with symptomatic second-, third-, and fourth-degree haemorrhoids, who underwent stapled haemorrhoidectomy by two independent minimally invasive surgeons at different hospitals. Patient’s demographic data, operative time, postoperative analgesic requirements, hospital stay and complications during the hospital stay and during the follow-up visit were collected on a prospectively designed computer-based proforma. Results: Mean operative time was 28.22 + 12.31 minutes; however, it varied between the different grades of haemorrhoids. The mean operative time was significantly more in patients having fourth-degree haemorrhoids and circumferential mucosal prolapse. The post-operative pain scores as measured by Visual Analogue Scale were also significantly more in the patients with fourth-degree haemorrhoids. Out of the 92 patients that underwent stapled haemorrhoidectomy, 88 (95.65%) patients were discharged on the first post-operative day with-in 24 hours of admission. Conclusion: Stapled hemorrhoidectomy is a safe and effective technique for the operative management of haemorrhoidal disease that can be performed as a day care procedure.