Comparison of Transanal Suture Rectopexy With Stapled Haemorrhoidopexy in Patients of Haemorrhoids: A Randomized Control Trial

Aim: To compare the transanal suture rectopexy with stapled haemorrhoidopexy in patients of haemorrhoids from clinical perspective. Methods: From January 2014 to January 2016, Eighty patients of haemorrhoids from grade II to IV were randomly assigned to undergo either the transanal suture rectopexy (n= 40) or the stapled haemorrhoidopexy (n=40). Outcome assessment was performed at 12 hours,24 hours, 2 days, 1 month and at 6 months. Variables included operative time, post-operative complications, resolution of symptoms, and recurrence. Results: Both the groups were comparable in terms of demographic data. No statistically significant difference was found between two groups in terms of operative time, post-op discomfort, urinary retention and VAS score at 24 and 48 hours. However the mean requirement of doses of analgesic diclofenac sodium (0.85 and 1.5 for the TR and SH group) differed significantly. Four patients in SH group developed prolapse at one month of post-op period, while in TR group this count was zero (P = 0.040). At six months of follow up seven patients of SH group had per rectal bleeding while only one patient from TR group has developed bleeding (P = 0.025). Four patients of the SH group had prolapse while no patient of TR group still had developed prolapsed at six month (P = 0.40). Patients rated TR as a better procedure than SH. Conclusion: Though transanal suture rectopexy has similar operative time, and resolution of symptoms when compared to stapled haemorrhoidopexy; it certainly offers lower incidence of post-op pain and long term recurrence than stapled haemorrhoidopexy