Comparison of efficacy of internal sphincterotomy versus topical 0.2 % glyceryl trinitrate ointment after hemorrhoidectomy.

Authors

  • Muhammad Arif Lahore General Hospital Lahore.
  • Sabih Nofal Lahore General Hospital Lahore.
  • Ahsan Khan Lahore General Hospital Lahore.
  • Mariam Tariq Awana Fatima Memorial Hospital, Lahore.
  • Anum Arif Combine Military Hospital, Lahore.

DOI:

https://doi.org/10.29309/TPMJ/2020.27.12.4728

Keywords:

Glyceryl Trinitrate, Hemorrhoidectomy, Lateral Internal Anal Sphincterotomy, Post-Operative Pain

Abstract

Objectives: To compare the efficacy of 0.2% glyceryl trinitrate ointment versus internal sphincterotomy after hemorrhoidectomy. Study Design: Randomized Controlled Trial. Setting: Department of Surgery Unit III, at Lahore General Hospital, Lahore. Period: 6 months (August 2017 to February 2018). Material & Methods: The OPD of the Department of Surgery included 124 patients who satisfied the inclusion criteria. There were two groups of patients, Group A and Group B. Group-A was told to use gloved finger three times daily for 0.2 percent GTN ointment topically. For Group B, lateral internal sphincterotomy was performed as day care procedure. On visit, patients were assessed for pain relief by using VAS. All data was collected using a pre-designed (attached) proforma. In SPSS v23.0 the data were input and analyzed. It was stratified for age, sex, disease duration and hemorrhoid stage. The effectiveness of both groups was compared by using a p-value of 0.05 as significant for a chi-square test. Results: Male predominance; in group-A, 41(66.1%) patients were male and 21(33.9%) were female, while in group-B, 52(83.9%) patients were male and 10(16.1%) were females. Efficacy was found in 11(17.7%) patients in group-A (0.2% GTN) while in 25(40.3%) patients in group-B (Internal sphincterotomy) with p-value of 0.006 which is statistically significant. Conclusion: Open hemorrhoidectomy internal sphincterotomy is an effective method to reduce pain after hemorrhoidectomy in contrast to Glyceryl Trinitrate (GTN) topical cream of 0.2 percent.

Author Biographies

Muhammad Arif, Lahore General Hospital Lahore.

MBBS, FCPS

Medical Officer General Surgery

Sabih Nofal, Lahore General Hospital Lahore.

MBBS, FCPS

Medical Officer General Surgery

Ahsan Khan, Lahore General Hospital Lahore.

MBBS

Medical Officer General Surgery

Mariam Tariq Awana, Fatima Memorial Hospital, Lahore.

MBBS

House Officer

Anum Arif, Combine Military Hospital, Lahore.

MBBS, FCPS

Classified General Surgeon

Fellow Vascular Surgery

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Published

2020-12-10