Suture haemorrhoidectomy: a day-only alternative

Haemorrhoidectomy is a common treatment for third degree symptomatic haemorrhoids, and day surgery has increased because of increasing pressure for hospital beds. The aim of the present study is to describe a technique of suture haemorrhoidectomy (SH), conducted as a day-only procedure, and compare the effectiveness and outcomes of this method with the conventional Milligan-Morgan haemorrhoidectomy (MMH).

The results of 18 consecutive patients, mean age 52 years (31-73) undergoing SH between April 1994 and June 1995 were compared with a historical control group of 17 consecutive patients, mean age 45 years (29-72), who had MMH in the preceding year. Seven patients were excluded because of intercurrent anal pathology (1), thrombosed haemorrhoids (1) or loss to follow-up (5). An interviewer followed up patients using a telephone questionnaire.

Mean follow-up was 6 months in the SH group and 18 months in the MMH group. There was no significant difference in total operative time. The SH group had a significantly shorter mean time to first void of 3 h versus 11 h (P < 0.005), mean time to first bowel action of 11 h versus 48 h (P < 0.005) and mean in-hospital stay of 10 h versus 77 h (P < 0.005). The SH group had a significantly decreased linear analogue pain scale, a mean of 1 versus 3 (P < 0.05). The complications were: two readmissions for pain relief in the SH group and urinary retention in one MMH patient. None of the study group have had recurrence of haemorrhoids.

Suture haemorrhoidectomy as a day-only procedure is safe, less painful and reduces in-hospital admission time. The long-term effectiveness and complications of the technique are as yet undetermined.