SUTURE HAEMORRHOIDECTOMY: A DAY‐ONLY ALTERNATIVE

Abstract

Background: 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).Methods: 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.Results: 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.Conclusion: 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.