Prospective Observational Comparative Study on the Outcomes of Open Haemorrhoidectomy versus Stapled Haemorrhoidopexy in Grade III and Grade IV Haemorrhoids

Abstract

AIM: to compare the outcomes of open haemorrhoidectomy and stapled hemorrhoidopexy in patients with Grade III and Grade IV haemorrhoids.

PATIENTS AND METHODS: this prospective observational comparative study was conducted at Kasturba medical college, Manipal, from March 2023 to March 2025. 26 patients undergoing open haemorrhoidectomy and 26 patients undergoing stapled hemorrhoidopexy were compared. Parameters assessed included operative time, postoperative pain (VAS on POD 1 and 3), analgesic requirement, bowel activity, urinary retention, postoperative bleeding, duration of hospital stay, return to work, and follow-up outcomes.

RESULTS: grade III haemorrhoids accounted for 88.5% of cases. Operative time was similar in both groups (median: 60 minutes). Postoperative pain scores and analgesic needs showed no significant difference. Urinary retention was significantly higher in the stapled group (34.6%) compared to the open group (11.5%). Other parameters, including return to work and complication rates, were comparable.

CONCLUSION: both open haemorrhoidectomy and stapled hemorrhoidopexy are effective in treating advanced haemorrhoids. However, stapled hemorrhoidopexy demonstrated a higher incidence of urinary retention. Surgical approach can be individualized based on patient profile and resource availability.