“Comparative study in the management of haemorrhoids by minimal invasive procedure for haemorrhoid (miph), barron’s banding with surgical excision”

Background: Haemorrhoids are one of the commonest conditions encountered in our surgical OPD. To treat this condition we have a wide range of treatment modalities. Our study intends to know the various modes of presentation in our practice namely MIPH, Barron’s banding and surgical excision and also compare the efficacy of these procedures, and study the common post operative complications.
Methods: Patients provisionally diagnosed to have haemorrhoids by clinical evaluation were selected for the study. A total number of 30 patients were studied in each group for this randomized study. Patients were selected consecutively during study period as and when they were presented with following inclusion and exclusion criteria.
Results: In our present study, 76% were male patients. The mean age of presentation was 39.4 years, bleeding was the commonest symptom which was seen in 73.3%. Straining was seen in 51.1%, pain as a presenting complaint is seen in 43.3% Post operative evaluation revealed pain to be the important factor in 90% of open haemorrhoidectomy group and only 6.7% in banding group. Bleeding occurred in 36.7% of the patients in haemorrhoidectomy group, while it occurred in 16.7% of banding group and 10% of MIPH group. Retention of urine was seen in 13.3% of patients in haemorrhoidectomy group. Hospital stay was more in haemorrhoidectomy group which was 3.8 days, and 1.1days in MIPH group. Recurrence was comparable among all the three groups with banding showing 10 %, MIPH 10%, and haemorrhoidectomy 3.3%.
Interpretation and conclusion: In conclusion haemorrhoids have a male preponderance. It usually occurs mostly in the mid 40’s. Bleeding is one of the commonest modes of presentation, with straining, hard stools and pain being others. MIPH has least postoperative complication like bleeding and less hospital stays, and least recurrence. Haemorrhoidectomy has more postoperative complication like pain, bleeding and more hospital stay. Banding has less postoperative complications, but should be done in appropriately selected cases. The recurrence rate was slightly more in banding.