Postoperative complications associated with open versus closed haemorrhoidectomy

Objective: was to compare the effectiveness of open and closed haemorrhoidectomy for 3rd and 4th degree prolapsing and complicated internal haemorrhoids in our local population in terms of postoperative complications . study design: cross-sectional,comparative study . materials and methods: 80 patients were divided equally into two groups of 40 each : group a and group b . patients in group a were operated by the open haemorrhoidectomy technique while those in group b were operated by the closed haemorrhoidectomy technique. result: at first follow up visit,wound healing was assessed to be incomplete in all the 80 patients ; pain was reported by 53 ( 66.3% ) patients in total; complain of bleeding was present in 24 (30.0%) patients in total; infection/sepsis was present in 41(51.3%) patients in total; urinary retention was reported by 19(23.8%) patients in total; fecal incontinence was present in 9(11.3%) patients in total; anal stenosis was exhibited by 43 (53.8%) patients; and recurrence was present in 3(3.8%) patients in total. at the second follow up visit,wound healing was assessed to be incomplete in 45(56.3%) patients; pain was present in 6(7.5%) patients only; complain of bleeding was present in 5(6.3%) patients only; infection/sepsis was seen in 17(21.3%) patients in total; urinary retention was reported by 2(2.5%) patients only; fecal incontinence was reported by 6(7.5%) patients in total; anal stenosis was present in 40(50.0%) patients; and recurrence was present in 6(7.5%) patients in total. at the third follow up visit,wound healing was assessed to be incomplete in 4(5.0%) patients only; pain was not present in any patient; complain of bleeding was presented by 6(7.5%) patients only; infection/sepsis of the surgical site was seen in 10(12.5%) patients in total; urinary retention was again not present in any of the patients; fecal incontinence was reported by 5(6.3%) patients only; anal stenosis was present in 22(27.5%) patients in total; and recurrence was exhibited by 7(8.8%) patients in total. conclusion: both open and closed haemorrhoidectomy techniques were equally beneficial to the patient because they both showed an almost similar pattern of postoperative complications . closed haemorrhoidectomy technique led to an earlier wound healing than the open technique . chances of development of anal stenosis were relatively higher after a closed haemorrhoidectomy as compared to the open haemorrhoidectomy .