Our Summary

This research paper compares two types of surgery for treating severe hemorrhoids: Stapled Hemorrhoidectomy (SH) and Open Hemorrhoidectomy (OH). These methods have been studied to determine their effects on gut function and pain management. The research involved a thorough search of several databases for scientific studies comparing the two methods. They looked at how quickly patients could resume a normal diet and bowel movements after surgery, as well as how well pain was managed.

The study found that the SH method was generally better than the OH method in terms of managing pain, helping the gut return to normal, and reducing the length of hospital stays. Patients who underwent SH reported less pain, used less pain medication, and recovered faster. They also had their first bowel movement sooner than those who underwent OH. However, the study also found that patients who underwent SH were more likely to have their hemorrhoids come back, especially between 12 to 18 months after surgery.

In conclusion, SH has some significant short-term advantages over OH, like less post-surgery pain, quicker recovery, and fewer complications. However, because of the higher chance of hemorrhoids recurring with SH, doctors should consider the long-term outcomes when deciding on the best surgical method for treating severe hemorrhoids.

FAQs

  1. What are the main differences between Stapled Hemorrhoidectomy (SH) and Open Hemorrhoidectomy (OH) as found in the study?
  2. What are the short-term benefits of choosing SH over OH for treating severe hemorrhoids?
  3. Does the SH method have a higher chance of hemorrhoids recurring compared to the OH method?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hemorrhoidectomy is to carefully follow post-operative instructions to ensure proper healing and minimize the risk of complications. This may include taking prescribed pain medication, keeping the surgical area clean and dry, eating a high-fiber diet to prevent constipation, and avoiding straining during bowel movements. It is important to also attend follow-up appointments with your doctor to monitor your recovery progress and address any concerns or complications that may arise.

Suitable For

Patients who are typically recommended for hemorrhoidectomy are those with severe hemorrhoids that do not respond to more conservative treatments such as dietary changes, topical medications, or rubber band ligation. These patients may experience symptoms such as persistent pain, bleeding, itching, or prolapse of hemorrhoids. Additionally, patients with large external hemorrhoids or thrombosed hemorrhoids may also be candidates for hemorrhoidectomy. It is important for patients to discuss their symptoms and treatment options with a healthcare provider to determine the most appropriate course of action.

Timeline

Before hemorrhoidectomy:

  1. Patient experiences symptoms of hemorrhoids such as bleeding, itching, and discomfort.
  2. Patient may try conservative treatments such as topical creams, dietary changes, and sitz baths to alleviate symptoms.
  3. If conservative treatments are ineffective, patient may consult with a doctor who may recommend surgery as a treatment option.

After hemorrhoidectomy:

  1. Patient undergoes surgery, either SH or OH, to remove the hemorrhoids.
  2. In the immediate post-operative period, patient may experience pain and discomfort, which can be managed with pain medication.
  3. Patient is typically discharged from the hospital within a few days.
  4. In the following weeks, patient may gradually resume normal activities and diet.
  5. Patient may experience some post-operative complications such as bleeding, infection, or difficulty with bowel movements.
  6. Depending on the surgical method used, patient may have varying rates of recovery and pain management.
  7. Long-term follow-up may be necessary to monitor for recurrence of hemorrhoids.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with hemorrhoidectomy surgery?
  2. How long is the recovery process after hemorrhoidectomy surgery?
  3. Will I need to take time off work or make any lifestyle changes during my recovery?
  4. What type of pain management options will be available to me after surgery?
  5. How likely is it that my hemorrhoids will come back after surgery?
  6. Are there any alternative treatments or procedures that I should consider before opting for surgery?
  7. How experienced are you in performing hemorrhoidectomy surgeries?
  8. What can I do to prepare for surgery and optimize my recovery?
  9. Will I need to follow any specific diet or exercise regimen after surgery?
  10. How will my bowel movements be affected after surgery, and when can I expect them to return to normal?

Reference

Authors: Khalid S, Laghari ZH, Rafiq MK, Khan G, Manzoor H, Biju Seena P, Hussain S, Khatoon F, Ayyub Kantharia F, Kantharia SF. Journal: Cureus. 2025 Feb 19;17(2):e79305. doi: 10.7759/cureus.79305. eCollection 2025 Feb. PMID: 40125221