Surgery

Biography

Biography: Ahmed Abdel Monem

Abstract

Background: Hemorrhoidectomy offers the best chances of permanent cure of symptomatic grades-3 and 4 hemorrhoids. The main drawback of hemorrhoidectomy is the uncomfortable pain in the first postoperative week as this surgical procedure commonly creates three raw areas in the anal region. Performing the procedure that helps in healing these raw areas definitely helps to alleviate postoperative pain and discomfort. Aim: is to evaluate the role of internal sphincterotomy in addition to routine open hemorrhoidectomy. Material and Methods: seven hundreds patients with second, third or fourth degree hemorrhoids, were enrolled in this study divided into two groups. Group I managed by open hemorrhoidectomy and posterior internal sphincterotomy and Group II managed by open hemorrhoidectomy alone without sphincterotomy. Patients were given routine postoperative analgesics and other drugs. Our observation included severity of pain, hospital stay, post-operative complications and return to normal activities. The need of analgesics in the postoperative course was also observed. Results: post-operative pain was significantly improved in Group I than in Group II. Patients in Group I had significant lower rate of post-operative infection and also significant lower No. of doses of pain killer either oral or injectable. There was no significant difference in duration of hospital stay between both groups. Conclusion: Adding internal sphincterotomy along with internal hemorrhoidectomy improved the post-operative pain, also decreased rate of post-operative infection and it was well tolerated by patients.