Post-operative complications of stapled versus Ferguson hemorrhoidectomy at Mulago Hospital. A randomized comparative study

Abstract

Background: Hemorrhoids are a common anorectal condition. New surgical treatments have led to a reappraisal of hemorrhoid disease over the last few decades and despite a range of treatment modalities, the options are limited in their effectiveness and can lead to a number of complications. This study set out to compare post operative complications between stapled haemorrhoidopexy (SH) and Ferguson haemorrhoidectomy (FH) for patients with Grade III and IV in Mulago National Referral and teaching Hospital.

Methods: Following ethical approval 48 consenting participants with Grade III/IV hemorrhoids were randomized to either FH or SH under regional anesthesia on 1:1 allocation. Early and short term post-operative complications were analyzed. .

Results: We enrolled 24 participants in each arm with equal sex allocation and mean age of 39 years with 100% follow up. There was largely no difference in early and short term complications between FH and SH save for bleeding in the short term follow up which occurred more frequently in the FH group (p-value 0.045). The bleeding was mild and did not require transfusion.

Conclusion: There was no major difference in short term complication rates between SH and FH. SH is a safe alternative to FH in Mulago Hospital.

Keywords: Ferguson hemorrhoidectomy. Stapled hemorrhoidopexy. Hemorrhoids.PPH, Mulago Hospital, colorectal surgery