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A comparison between open and closed hemorrhoidectomy.

Khalil-ur-Rehman1, Azmat Hasan, Muhammad Taimur

  • 1Department of Surgery, Fauji Foundation Hospital, Rawalpindi, Pakistan.

Journal of Ayub Medical College, Abbottabad : JAMC
|July 27, 2012
PubMed
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Closed hemorrhoidectomy offers better wound healing and less bleeding but may cause more pain compared to open hemorrhoidectomy. This study compared outcomes for both surgical techniques.

Area of Science:

  • Colorectal Surgery
  • Surgical Outcomes Research

Background:

  • Hemorrhoidectomy can lead to complications like pain, bleeding, and infection, potentially prolonging hospital stays.
  • Both open and closed hemorrhoidectomy techniques aim for improved postoperative pain and wound healing.
  • Comparative analysis of surgical methods is crucial for optimizing patient care.

Purpose of the Study:

  • To compare postoperative pain, bleeding, operating time, and wound healing between open and closed hemorrhoidectomy.
  • To evaluate the efficacy and safety of different hemorrhoidectomy approaches.
  • To inform clinical decision-making regarding the preferred surgical technique for hemorrhoids.

Main Methods:

  • A comparative study involving 260 patients with 3rd and 4th-degree hemorrhoids.

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  • Patients were consecutively assigned to either open or closed hemorrhoidectomy groups (130 each).
  • Diagnosis was confirmed via digital rectal examination and proctoscopy.

    • Main Results:

    • The closed group showed significantly better complete wound healing at 2 weeks (p<0.001) compared to the open group.
    • Postoperative pain was reported as severe in 13 patients in the closed group versus none in the open group.
    • Postoperative bleeding (early and late) was comparable between the open and closed hemorrhoidectomy groups.

    Conclusions:

    • Closed hemorrhoidectomy demonstrates superior wound healing and reduced postoperative bleeding.
    • However, the closed technique is associated with a higher incidence of postoperative pain.
    • The choice between open and closed hemorrhoidectomy involves balancing wound healing and pain management.