~ 217 ~ International Journal of Surgery Science 2019; 3(4): 217-219 E-ISSN: 2616-3470 P-ISSN: 2616-3462 © Surgery Science www.surgeryscience.com 2019; 3(4): 217-219 Received: 11-08-2019 Accepted: 15-09-2019 Sadashiv V Patil Department of General Surgery, Khaja Banda Nawaz Institute of Medical Sciences, Kalaburagi, Karnataka, India Medide Veerendra Department of General Surgery, Khaja Banda Nawaz Institute of Medical Sciences, Kalaburagi, Karnataka, India Nandkishor Shinde Department of General Surgery, Khaja Banda Nawaz Institute of Medical Sciences, Kalaburagi, Karnataka, India Corresponding Author: Medide Veerendra Department of General Surgery, Khaja Banda Nawaz Institute of Medical Sciences, Kalaburagi, Karnataka, India Management of haemorrhoids in tertiary care centre Sadashiv V Patil, Medide Veerendra and Nandkishor Shinde DOI: https://doi.org/10.33545/surgery.2019.v3.i4d.243 Abstract Aim: To evaluate the outcome of sclerotherapy and closed haemorrhoidectomy. Materials & Methods: 24 patients of anorectal disease were included and were operated in this period, 7 patients underwent closed haemorrhoidectomy, 9 patients were given sclerotherapy. Patients of anorectal abscess were excluded and correction of anemia done followed by posted to surgery. Grade I and II Haemorrhoids were treated with sclerosant and Grade III and IV are treated with closed haemorrhoidectomy. Both procedures were done under spinal anesthesia. Results: 7 patients underwent closed haemorrhoidectomy and 9 patients underwent sclerotherapy. Postoperative complications in both groups were studied like pain, bleeding per rectum, mucosal discharge, urinary discharge and wound dehiscence are treated and follow up done. No case arrived with any symptoms of recurrence in the follow up of next 6 months. Conclusion: Sclerotherapy is the preferred technique for hemorrhoids (especially Grade I & II) with minimal duration of stay, early return to the work and less post operative pain and it can be done as a daycare procedure. For Grade III& IV haemorrhoids, closed hemorrhoidectomy is ideal and beneficial. Keywords: Management, haemorrhoids, tertiary care centre Introduction Haemorrrhoids are cushion sinusoids and they can be either external or internal. The main complaints are bleeding during or after defecation, pain, itching, prolapse and perianal soiling [1, 2] . Haemorrhoids affect between 4.4 and 36.4% of the general population [3] . Hemorrhoids are one of the common clinical conditions affecting most of the population by the age of 50 years. They occur at any age and can affect both males and females [3] . Only in the last 30 years have anatomical [4] and histological [5] studies been used to characterise their anatomy and aetiology [3] . This has led to resurgence in interest in the condition, associated with the development of a number of novel treatments. The exact etiology is unknown but the condition usually encountered in people adopted with westernized life style [6] Ferguson and Heaton said, “Hundred percent of the population does suffer from haemorrhoids at least once in their lifetime” [7] There are numerous modalities of treatment, namely, rubber band ligation, infrared photocoagulation, bipolar diathermy, sclerotherapy, cryotherapy, hemorrhoidectomy (open/closed), anal dilation, pile stitching. Among the newer ones, stapled hemorrhoidopexy performed using the circular anal stapler is recent advancement which have got enormous appreciation [3, 4] . Sclerotherapy is the procedure to treat first, second and some third degree haemorrhoids. Complications are very few with this procedure, though infection and fibrosis have been reported in some studies. In clinical practice, III rd & IV th degree internal hemorrhoids are the main indication for hemorrhoidectomy. Other Indications for hemorrhoidectomy include acute complicated haemorrhoids such as strangulation or thrombosis. Closed (Ferguson) hemorrhoidectomy and Open (Milligan-Morgan) hemorrhoidectomy are equally effective and safe, but Ferguson method is superior to the Milligan-Morgan method in term of long time patient satisfaction and continence. In our study we have done closed hemorrhoidectomy in all our patients. Aim The present study, evaluates the outcome of sclerotherapy and closed haemorrhoidectomy.