European Journal of Cardiovascular Medicine

Introduction: Haemorrhoids of grade 3-4 and prolapsed haemorrhoids need surgery. Previously, surgeons used to perform Milligan-Morgan open technique, but after the introduction of stapler haemorrhoidopexy, most surgeons prefer this technique. It involves the removal of rectal mucosa and haemorrhoidal tissue 4 centimetres above the dentate line. Stapler haemorrhoidopexy in the recent past has been accepted as the preferred modality of surgery for grade 3 and 4 haemorrhoids, though traditional method of open haemorrhoidectomy is still performed. Various previous studies have proved that stapler and open technique have the same results in efficacy but the complications are lesser with stapler haemorrhoidopexy.

Aim: To correlate the presence of muscle fibres in the doughnut of stapler haemorrhoidopexy with post-operative complications.

Results: This is an observational study conducted in 80 patients who underwent stapler haemorrhoidopexy for internal haemorrhoids. Most of the patients are between 20 to 40 years (42.5%) with mean age of 36 years. Early post-operative complications in patients with muscle fibres in donut of stapler haemorrhoidopexy specimen were mainly post-operative pain. All 7 patients (100%) suffered from severe pain at operative site i.e. VAS score > 6 (p- < 0.001**). 5 out 7 patients (71.4%) patients had post- operative urinary retention (p-0.009**) and post-operative bleeding per rectum is seen in all 7 cases (p- < 0.001**). All the early post-operative complications are strongly clinically and statistically significant. And in late post-operative complications proctalgia was seen in 3 (42.9%) patients (p- < 0.001**) which was also strongly clinically and statistically significant.

Conclusion: Early complications like post-operative pain, urinary retention and post-operative haemorrhage in patients with muscle fibre in donut are clinically and statistically significant. (P- < 0.001**). Late complications like proctalgia is clinically and statistically significant. (P- <0.001**).

An experienced surgeon and proper stapler haemorrhoidopexy technique is required to avoid such complications