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Hemorrhoidectomy and sphincterotomy

A prospective study comparing the effectiveness of anal stretch and sphincterotomy in reducing pain after hemorrhoidectomy

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Diseases of the Colon & Rectum

Abstract

The effectiveness of two maneuvers, anal stretch (group 1) and sphincterotomy (group 2), were evaluated in reducing posthemorrhoidectomy pain. The study included 133 patients in group 1 and 125 patients in group 2. Immediate follow-up results showed that 18.4 percent of patients in group 2 required narcotic analgesics in the first 24 hours as compared with 100 percent of group 1 patients (P<.01). Urinary retention developed in 4 percent of the patients in group 2 and 39 percent of the patients in group 1 (P<.01). Pain associated with the first postoperative motion was severe in 96.2 percent of those in group 1 as compared with 6.4 percent of patients from group 2 (P<.01). Moreover, long-term follow-up showed that 57.3 percent of group 1 patients continued to suffer from fecal soiling for ten weeks as compared with 6.4 percent in group 2 who suffered only for 4.5 weeks (P<.01). The routine performance of sphincterotomy through one of the hemorrhoidectomy wounds significantly reduced posthemorrhoidectomy pain and complications.

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References

  1. Jones CB, Schofield PF. A comparative study of the methods of treatment for haemorrhoids. J R Soc Med 1974;67:51–3.

    CAS  Google Scholar 

  2. Murie JA, Mackenzie I, Sim AJ. Comparison of rubber band ligation and haemorrhoidectomy for second- and third-degree haemorrhoids: a prospective clinical trial. Br J Surg 1980;67:786–8.

    PubMed  CAS  Google Scholar 

  3. Goligher JC. Surgery of anus, rectum and colon. 5th ed. London: Bailliere Tindall, 1984:98.

    Google Scholar 

  4. Parks AG. The surgical treatment of haemorrhoids. Br J Surg 1956;43:337–51.

    PubMed  CAS  Google Scholar 

  5. Eisenhammer S. Internal anal sphincterotomy plus free dilatation versus anal stretch, with special criticism of the anal stretch procedure for hemorrhoids: the recommended modern approach to hemorrhoid treatment. Dis Colon Rectum 1974;17:493–521.

    PubMed  CAS  Google Scholar 

  6. Eisenhammer S. Proper principles and practices in the surgical management of hemorrhoids. Dis Colon Rectum 1969;12:288–305.

    PubMed  CAS  Google Scholar 

  7. Allgower M. Conservative management of haemorrhoids. Part III. Partial internal sphincterotomy. Clin Gastroenterol 1975;4:608–18.

    Google Scholar 

  8. Watts JM, Bennett RC, Duthie HL, Goligher JC. Pain after hemorrhoidectomy. Surg Gynecol Obstet 1965;120:1037–42.

    PubMed  CAS  Google Scholar 

  9. Milligan ET, Morgan CN, Jones LE, Officer R. Surgical anatomy of the anal canal, and the operative treatment of haemorrhoids. Lancet 1937;2:1119–24.

    Article  Google Scholar 

  10. Notaras MJ. The treatment of anal fissure by lateral subcutaneous internal sphincterotomy: a technique and results. Br J Surg 1971;58:96–100.

    PubMed  CAS  Google Scholar 

  11. Recamier JC. Extension, massage et percussion cadencée dans le traitement des contractures musculaires. Rev Med Fr Estrang 1838;1:74.

    Google Scholar 

  12. Maisonneuve JG. Clinique chirurgical. Paris: F Savy, 1864;2:200.

    Google Scholar 

  13. Watts JM, Bennett RC, Goligher JC. Stretching of anal sphincters in treatment of fissure-in-ano. Br Med J 1964;2:342.

    PubMed  CAS  Google Scholar 

  14. Bodenhamer W. Practical observations on the aetiology, pathology, diagnosis, and treatment of anal fissure. New York: W Wood, 1868:199.

    Google Scholar 

  15. Spiesman MG. Essentials of clinical proctology. New York: Grune & Stratton, 1946:238.

    Google Scholar 

  16. Watts JM, Bennett RC, Duthie HL, Goligher JC. Healing and pain after haemorrhoidectomy. Br J Surg 1964;51:808–17.

    PubMed  CAS  Google Scholar 

  17. Goligher JC, Graham NG, Clark CG, De Dombal FT, Giles G. The value of stretching the anal sphincters in the relief of post-haemorrhoidectomy pain. Br J Surg 1969;56:859–63.

    PubMed  CAS  Google Scholar 

  18. Hancock BD. How do surgeons treat haemorrhoids? Ann R Coll Surg Engl 1982;64:397–400.

    PubMed  CAS  Google Scholar 

  19. Read MG, Read NW, Haynes WG, Donnelly TC, Johnson AG. A prospective study of the effect of haemorrhoidectomy on sphincter function and faecal continence. Br J Surg 1982;69:396–8.

    PubMed  CAS  Google Scholar 

  20. Snooks S, Henry MM, Swash M. Faecal incontinence after anal dilatation. Br J Surg 1984;71:617–8.

    PubMed  CAS  Google Scholar 

  21. Eisenhammer S. The surgical correction of chronic internal anal (sphincteric) contracture. S Afr Med J 1951;25:486–9.

    PubMed  CAS  Google Scholar 

  22. Jensen SL, Lund F, Nielsen OV, Tange G. Lateral subcutaneous sphincterotomy versus anal dilatation in the treatment of fissure in ano in out-patients: a prospective randomised study. Br Med J 1984;289:528–30.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Amiri Teaching Hospital, P.O. Box 2336, 22024, Salmiya, Kuwait

    Sami K. Asfar M.D. (U.K.), F.R.C.S.Ed., F.A.C.S., Taleb H. Juma M.B., B.S., F.R.C.S.I. & Tareef Ala-Edeen M.B., Ch.B.

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  1. Sami K. Asfar M.D. (U.K.), F.R.C.S.Ed., F.A.C.S.
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  2. Taleb H. Juma M.B., B.S., F.R.C.S.I.
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  3. Tareef Ala-Edeen M.B., Ch.B.
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Asfar, S.K., Juma, T.H. & Ala-Edeen, T. Hemorrhoidectomy and sphincterotomy. Dis Colon Rectum 31, 181–185 (1988). https://doi.org/10.1007/BF02552543

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  • DOI: https://doi.org/10.1007/BF02552543

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