Comparison of outcomes, with and without lateral internal Sphincterotomy, in patients undergoing open Haemorrhoidectomy

Abstract

Background: Piles are considered to be a frequently occurring problem in local population. Haemorrhoidectomy is the procedure of choice which is performed to rectify the problem. Usually 3 rough areas are created in the anal area by this surgical modality. The significance of doing associated lateral internal sphincterotomy for pain control in patients who underwent haemorrhoidectomy remains controversial in the literature. Aim: To conduct this study and compare the outcome with or without lateral internal sphincterotomy. Methodology: So this randomized controlled trial was performed for 1year. Sample size of 60 patients was enlisted through Non Probability, Convenient Sampling. Patients were divided in two equal groups. In group A, open haemorrhoidectomy was performed with LIS, whereas in group B, open haemorrhoidectomy was performed without LIS. After surgery, patients were followed-up for 48 hours and 2 weeks to assess post-operative pain,bleeding and incontinence. Results: The mean age of all cases was 45.57±7.92 years and there were 40 (66.7%) male and 20 (33.3%) females. At 48 hours of surgery, 10(33.37%) cases with LIS and 26(86.67%) cases without LIS had pain with significantly lower pain with LIS (p-value < 0.001), bleeding was present in 2(6.7%) cases with LIS vs. 3(10%) cases without LIS (p-value>0.05) and incontinence was noted in 2(6.7%) patients with LIS vs. 1 (3.3%) without LIS (p-value>0.05). At 2 weeks after surgery, pain was observed in 0 (0%) case with LIS and 6(20%) cases without LIS (p-value=0.010), bleeding in 2(6.7%) cases with LIS and 1 (3.3) patient without LIS (p-value >0.05) and incontinence in 1(3.3%) patients with LIS and 0 (0%) patients without LIS (p-value >0.05). Conclusion: Through the findings of this we found that better outcome after open haemorrhoidectomy with lateral Internal Sphincterotomy in terms of less pain, but bleeding rate and incontinence was similar in both groups.