BACKGROUND Hemorrhoidal disease is a common reason for consultation in proctology and a public health problem responsible for discomfort and urgent request relief. Patients mostly complain of pain, discomfort, bleeding, and itching. Currently, combining an anoscope and a Doppler transducer makes it possible to detect and bind the arteries responsible for congestion selectively thereby reducing the blood flow and thus collapsing haemorrhoids. (1) Doppler-guided ligation of haemorrhoidal vessels is being proposed as a treatment of grade 2 and 3 haemorrhoids. (2) METHODS All patients attending the outpatient department of general surgery at Sri Siddhartha Medical College and Research Institute with characteristics of grade 2 and grade 3 haemorrhoids were included in the study. In this prospective study, we compared the results of open haemorrhoidectomy and DGHAL techniques by means of duration of surgery, postoperative pain, post-operative need for analgesics, post hospital stay, and complications. Ninety-six patients were enrolled in this study and were subsequently divided into two groups of 48 members in each. Group A patients received an open haemorrhoidectomy and Group B received a DGHAL. RESULTS Duration of surgery was for DG-HAL group is significantly lesser than open haemorrhoidectomy. Post-operative pain score using VAS was significantly lesser in DG-HAL than open haemorrhoidectomy. Post-operative need for analgesics was significantly lesser in DG-HAL than open haemorrhoidectomy. Post-operative hospital stay, and complications were significantly lesser in DG-HAL group than Open haemorrhoidectomy. CONCLUSIONS DG HAL repair seems to be a safe method of treatment of 2 nd and 3 rd grade haemorrhoidal disease with no major complications and a high rate of good shortterm results. DGHAL is more useful when compared to Milligan-Morgan technique in terms of duration of surgery, post-operative pain, post-operative need for analgesics, post-operative hospital stay, as DGHAL reduces the complications in surgery.
The skin stapling devices have revolutionized surgery for the purpose of rapid closure of abdominal wounds. However, staples have their own drawbacks. In view of this, this prospective study has been undertaken to highlight the outcomes of closure by staples and sutures with respect to speed of closure, cost effectiveness and post operative wound dehiscence, acceptance of scar and post operative pain. This is a prospective hospital based study conducted in our hospital from October 2009 to September 2011 involving a total of 200 patients who underwent abdominal surgery both on an emergency and elective basis. Results were analyzed and compared with previous studies.It has been found that the use of staples in abdominal surgical wound closure gives faster speed of closure, less postoperative pain, and better cosmetic results. Staples, however, are costlier, and when used in emergency cases, associated with higher rates of wound dehiscence and a less acceptable scar.
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