A prospective study of post-operative complications and its management following open hemorrhoidectomy in a tertiary care hospital

Abstract

Background: Surgery is the most effective treatment for hemorrhoids and is particularly recommended for prolapsing piles during defecation that may be reduced manually (Grade III) and irreducible hemorrhoids (Grade IV). Numerous methods have been proposed for surgical therapy, and most have similar success rates. But serious post-operative complications are rarer in open technique than stapled hemorrhoidopexy. Prompt identification of post-operative complications is necessary to avoid significant patient morbidity.

Aims and Objectives: The present study was done to access post-operative complications and their management, like post-operative pain, urinary retention, wound infection, bleeding, anal incontinence, and anal stenosis following open hemorrhoidectomy during the post-operative and follow-up periods.

Materials and Methods: This was an observational prospective study carried out at the Department of Surgery of Midnapore Medical College and Hospital from April 1, 2021, to September 30, 2022, with 100 patients.

Results: Out of 100 open hemorrhoidectomy cases, 74% belonged to the 31–50 year age group, 16% belonged to the 18–30 year age group, and only 10% were aged >50 years, respectively. The mean age of our study population was 40.62. Males were predominantly higher than females (79% vs. 21%). There was 7% of patients had bleeding per rectum, 22% had urinary retention, and 4% had wound infection after open hemorrhoidectomy. Mean and standard deviation value of post-operative pain score was found in post-operative day (POD-1) 6.15±0.85, POD-3- 4.25±0.99, POD-7- 2.43±1.40, after 28 days mean value pain score was 0.66±1.19, after 84 days mean pain score was 0.05±0.21. After 6 months of follow-up, there was no significant complication found.

Conclusion: We found that the important advantages of Milligan Morgan open hemorrhoidectomy achieve in terms of pain and wound healing, hospital stay. It was less expensive and safe, easy to perform with satisfactory results and in long run it did not have significant post-operative complication.