DOI: 10.36347/sasjs.2021.v07i06.010

Pages: 298-303

Hemorrhoids are one of the most common presentations of the anal canal [1]. Various treatment modalities have been described over the years. However, still hemorrhoidectomy offers the best chances of permanent cure of symptomatic hemorrhoids.[1, 2] The main complication of hemorrhoidectomy is the pain in the first postoperative week which is very uncomfortable to the patient [3]. The main cause of unpleasant post-hemorrhoidectomy pain is due to the spasm of the internal sphincter that is exposed after open hemorrhoidectomy[4, 5, 6]. Internal Sphincterotomy reduces post hemorrhoidectomy pain by abolishing the hypertonicity (spasm/pressure) of the internal anal sphincter and subsequently reduces the related post hemorrhoidectomy complications[7, 8, 9] The main aim of this study was to compare the postoperative pain and other postoperative complications in two groups of patients treated with open hemorrhoidectomy and open hemorrhoidectomy with internal sphincterotomy. In this Randomised-Control-Trial from October 2018 to April 2020, Group-A underwent open-hemorrhoidectomy and Group-B underwent open-hemorrhoidectomy and internal-sphincterotomy. They were analysed for Visual-Analog-Scale (VAS) for postoperative pain at 12 hours, 24 hours, 48 hours, Day 7, Wexner’s Score for fecal incontinence, duration of postoperative hospitalisation, return to work. Mean postoperative VAS of Group-A at 12 hours, 24 hours, 48 hours, Day-7 was 7.30, 5.03, 2.93, 1.47 respectively. For Group-B, postoperative VAS at 12 hours, 24hours, 48 hours, Day-7 was 6.10, 3.83, 2.00, 1.00 respectively. Mean duration of postoperative hospitalisation in Group-A was 3.6 days and Group-B was 2.6 days. Mean Wexner’s Score for fecal incontinence in Group-A was 0.00 and Group-B was 0.20. Mean duration of return to work in Group-A was 17.43 days and Group-B was 10.23 days. Results were analysed and were found to be statistically significant. Patients of Group-B (open hemorrhoidectomy with internal sphincteroto