Randomized trial of open versus sutured haemorrhoidectomy in Mulago Hospital in Kampala - Uganda

Abstract

Background: The aim of this study was to compare the early outcome of the conventional open with that of the sutured haernorrhoidectomy.
Method: Forty patients with symptomatic stage I11 and IV haemorrhoids were randomized to either conventional open haernorrhoidectomy (n=20) or sutured haernorrhoidectomy (n=20). All operations were performed under general anesthesia. Operative time, postoperative pain, duration taken to return to work, postoperative complications, wound healing rate and patient's satisfaction were recorded. Follow-up was weekly for four weeks.
Results: Open haernorrhoidectomy was easier and quicker to perform than sutured haernorrhoidectomy @-value 0.000). There was no statistically  significant difference in the average post-operative pain scores (P-value = 0.054). No difference in the need for extra analgesia was observed. The sutured haernorrhoidectomy resulted in faster rate of wound healing and earlier return to normal activity than open haernorrhoidectomy (p-value 0.027). The overall patient satisfaction score was 1.95 in the sutured group and 1.80 in the open group but this difference was not statistically significant @-value 0.159).
Conclusion: Sutured haernorrhoidectomy has a short-term clinical advantage over open haernorrhoidectomy in terms of rate of wound healing and earlier return to work. There was no statistically significant difference in degree of patient satisfaction.

Key words: Open, sutured and haernorrhoidectomy.