A Randomized Trial Comparing Stapled Rectal Mucosectomy Versus Open and Semiclosed Hemorrhoidectomy

Area of Science:

• Colorectal Surgery
• Surgical Outcomes Research
• Hemorrhoid Treatment

Background:

• Postoperative outcomes vary significantly across different surgical approaches for hemorrhoids.
• Existing literature lacks consensus on the optimal surgical technique for hemorrhoid management.

Purpose of the Study:

• To compare the postoperative outcomes of three primary surgical techniques for hemorrhoid treatment.
• To evaluate pain intensity and return to work timelines following open, semiclosed, and stapled hemorrhoidectomy.

Main Methods:

• A prospective, randomized trial involving 180 patients allocated into three groups (60 patients each).
• Comparison of open, semiclosed, and stapled hemorrhoidectomy techniques.
• Assessment of postoperative pain, analgesic requirements, and time to return to work.

Main Results:

• Semiclosed hemorrhoidectomy resulted in significantly less pain and reduced analgesic intake within the first week.
• Patients undergoing semiclosed and stapled techniques returned to work approximately 11 days post-surgery, compared to 21.3 days for open hemorrhoidectomy.
• Open hemorrhoidectomy was associated with a higher rate of complications, including stenosis.

Conclusions:

• Stapled and semiclosed hemorrhoidectomy procedures lead to earlier return to work and less pain than open surgery.
• Open hemorrhoidectomy is linked to increased complications, notably a higher incidence of stenosis.
• The study highlights the benefits of minimally invasive techniques in improving patient recovery after hemorrhoid surgery.