Outcome of Open haemorrhoidectomy versus Haemorrhoidal Artery Ligation in the treatment of Hemorrhoids Grade 3 and 4

Objective: To determine the comparative outcome of Open haemorrhoidectomy (OA) versus Haemorrhoidal Artery Ligation (HALs) with recto-anal repair (RAR) in the treatment of Hemorrhoids Grade 3rd and 4th at tertiary care Hospital. Material and methods: This comparative study was conducted at Isra university Hospital Hyderabad, from Jan 2017 and December 2017. All the patients presented with hemorrhoids grad III and IV and either of gender were included. Patients were divided in two groups. Patients of (HALs group) underwent HA +/- RAR and the patients of (OA group) underwent open haemorrhoidectomy. Outcome was evaluated in terms of post-operative complications including post-operative pain and hospital stay. All the data was collected via study proforma. Data was analyzed by using SPSS version 20 Results: Mean age of the patients HALs group was 34.56+4.22 years and OA group was 37.11+6.41. Males were in majority in both groups as 20(80.0%) in HALs and 16(64.0%) in OA group. Average postoperative pain (VAS) and post-operative Hospital stay were significantly lower in HALs group as compared to OA group (p=0.001), while average of operative time was significantly lower in OA group (p-0.001). Postoperative complications like urinary retention, bleeding and painful defecation were significantly higher in OA group as compared to Hals group (p=0.001). Conclusion: Haemorrhoidal Artery Ligation (HALs) with RAR found to be feasible and effective in terms of less post-operative pain, less complications and less hospital stay in contrast to Open haemorrhoidectomy (OA) in the treatment of 3rd and 4th degree Hemorrhoids.