مجله دانشکده پزشکی اصفهان (Mar 2011)
Open Surgical Hemorrhoidectomy with Minimal Bleeding
Abstract
• Background: Hemorrhoid disorders are common diseases and treated by multiple therapies such as symptom relief by medication, outpatient procedures, and surgical interventions in operation room are used. Surgical interventions include open and closed techniques. In many countries Milligan Morgan Hemorrhoidectomy (MMH) is the treatment of choice. The aim of present study was to introduce a new technique with minimal bleeding by primary ligation of hemorrhoidal vessels before hemorrhoidal tissue resection. • Methods: Patients with grade III or IV hemorrhoids were randomly divided into intervention or control groups. All patients operated by a single surgeon. In intervention group new technique were applied and control group were operated by traditional MMH procedure. Amount of bleeding during operation, and presence of post operative urinary retention were recorded for each patient. • Finding: Sixty two subjects were enrolled in this study and randomly assigned to intervention (n = 31) and control group (n = 31) by mean ages of 46.3 and 43.5 years respectively. The mean number of intraoperative bloody gauzes in intervention group was 2.1 ± 0.9 compared with 4.4 ± 1.5 in control group (P < 0.001). Prevalence of retention among intervention and control group was 9.7% (n = 3) and 3.2% (n = 1) respectively (P = 0.31). • Conclusion: Because intraoperative bleeding in the new technique is less than traditional MMH procedure (more than 50%), it is recommended that this procedure can lead to less blood loss and consequently shortened operation time and improve hemorrhoid resection by more visualization of surgical field.
