Yousaf Jan, Aurangzeb Khan, Waqas, Ahmad Din.
Open Heamorrhoidectomy under Local Anaesthesia.
Ophthalmol Update Jan ;12(1):69-71.

Objective: Haemorrhoids are engorged vascular cushions found within the submucosa of the anal canal. They consist of a sacculated venous plexus with a rich arterial supply supported by a fibromuscular connective tissue. The exact prevalence is unknown as many peoples do not seek medical attention; however, it may be somewhere in the region of 4-36% depending on population. The incidence is higher in Western populations and is low in sub-Saharan Africa. They normally contribute to the anal continence and protection of the sphincter mechanism during defecation and are found at constant positions within the anal canal (3, 7 and 11 o clock positions). The objective of my study is to assess the feasibility and tolerability of open haemorrhoidectomy under local anesthesia. Materials and Methods: This study was conducted in general surgery ward Hayatabad Medical Complex Peshawar after taking permission from research and ethical committee of the hospital. Through a prospective cross sectional study design, 65 patients were included in the study between March 2009 to March 2010. All patients underwent open haemorrhoidectomy by the same surgeon having more than five years experience. Both males and females were included in the study. Follow up was done after the surgery and the data were collected. Results: 65 patients with 3rd and 4th degree hemorrhoids underwent open haemorrhoidectomy under local anesthesia and including both male and female patients. The mean age was 44.4 ± 12.2 SD (21-72). Mean operating time was 20.7 min ± (9.9SD) (5-60min) SD. Only 5 patients (7%) had severe pain which needed general or spinal anesthesia. Conclusion: Hemorrhoidectomy under local anesthesia is feasible, effective, well tolerated and safe method in all age groups. It should be an alternative approach in treatment of haemorrhoidal disease who are unwilling or unfit for other forms of anesthesia.

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