The Role of Performing Lateral partial Internal Sphincterotomy in Patients Who Undergo Excisional Hemorrhoidectomy

SARC

The Role of Performing Lateral partial Internal Sphincterotomy in Patients Who Undergo Excisional Hemorrhoidectomy

Post published:July 30, 2023
Post author:Dr. Ayman Nadeem Kadum, Dr. Abdalrahman Hammad Turfa Al-Ani, Dr. Husham Fadhil Hussein Al-Asadi

Abstract

Background: Excisional hemorrhoidectomy is a commonly performed surgical procedure for treating hemorrhoids, however, postoperative pain is a significant concern. Lateral partial internal sphincterotomy (LIS) is a surgical technique that aims to alleviate postoperative pain by partially dividing the internal anal sphincter muscle. Objectives: This study aims to evaluate the effect of lateral internal sphincterotomy on postoperative pain and complications in those undergoing excisional hemorrhoidectomy. Patients and Method: This non-randomized controlled study was conducted from February 2020 to April 2022 at Al-Yarmouk Teaching Hospital. One hundred patients who underwent excisional haemorrhoidectomy were included in this research. Fifty patients with Hypertension and Fifty patients without hypertension. Fifty patients had an additional lateral internal sphincterotomy (LIS) procedure comprising the study arm, and Fifty patients did not have such procedure (control arm). Demographic data and data about postoperative pain and complications were recorded. Results: The mean age of the participants was 40.6 ± 10.7 years for the control arm and 35.9 ± 7.7 years for the study arm. Males constituted 66 and 76% of the total in the control and study groups, respectively. Postoperative pain in the first six hours and three days after surgery as well as following bowel movement was significantly less among patients undergoing LIS. However, no significant difference was noticed in pain severity in the first and second postoperative weeks. Bleeding was significantly of lower occurrence in the study group, while urine retention did not show any significant difference in frequency among both groups. Conclusion: Lateral internal sphincterotomy significantly reduces pain severity, especially in the early postoperative period with a decreased hospital stay. It also decreases some complications related to excisional hemorrhoidectomy such as bleeding.