Randomized trial of open versus sutured haemorrhoidectomy in Mulago Hospital in Kampala - Uganda.

Background: The aim of this study was to compare the early outcome of the conventional open with that of the sutured haernorrhoidectomy.
Method: Forty patients with symptomatic stage III and IV haemorrhoids were randomized to either conventional open haernorrhoidectomy (n=20) or sutured haernorrhoidectomy (n=20). All operations were performed under general anesthesia. Operative time, postoperative pain, duration taken to return to work, postoperative complications, wound healing rate and patient's satisfaction were recorded. Follow-up was weekly for four weeks.
Results: Open haernorrhoidectomy was easier and quicker to perform than sutured haernorrhoidectomy (p-value 0.000). There was no statistically significant difference in the average post-operative pain scores (P-value = 0.054). No difference in the need for extra analgesia was observed. The sutured haernorrhoidectomy resulted in faster rate of wound healing and earlier return to normal activity than open haernorrhoidectomy (p-value 0.027). The overall patient satisfaction score was 1.95 in the sutured group and 1.80 in the open group but this difference was not statistically significant p-value 0.159).
Conclusion: Sutured haernorrhoidectomy has a short-term clinical advantage over open haernorrhoidectomy in terms of rate of wound healing and earlier return to work. There was no statistically significant difference in degree of patient satisfaction.