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Haemorrhoids is one of the most common problem that a Surgeon faces in his day to day practice. The diagnosis of hemorrhoids is clinched by clinical and proctoscopic examination. The disease is graded based on bleeding or mass descending per rectum and treated accordingly. Grade III hemorrhoids are prolapsed masses that do not reduce spontaneously and reuire digital reposition. This study compares the efficacy of three procedures namely open hemorrhoidectomy and Rubber Band Ligation(RBL) in the treatment of third degree Hemorrhoids in the subjects presenting to the surgical out patient department of GMKMCH, Salem, Tamilnadu. This study was conducted in 75 random cases of third degree hemorrhoids over a period ofone and half years from Dec 2012 to Aug 2014. Out of 75 cases, 225 cases were subjected to open hemorrhoidectomy, 25 cases to closed hemorrhoidectomy and 25 cases to RBL, after obtaining written consent and a prior proctoscopic examination to rule out other associated diseases of the rectum and anal canal. Patients with other associated diseases like malignancy, fissure were excluded from the study. All parameters were recorded and analysed finally using SPSS statistical package. Hemorrhoidectomy achieves slightly better results than RBL in the management of third degree haemorrhoids. However RBL, being an outpatient procedure, can be easily applied on patients unfit for spinal anaesthesia and those with bleeding disorders. Hence RBL could be recommended in those patients in whom anaesthesia is contraindicated. Ultimately open hemorrhoidectomy achieves better results than RBL in the treatment of third degree haemorrhoids.

Comparative Study of Outcome of Open Vs Closed Hemorrhoidectomy Vs Rubber Band Ligation in Third Degree Haemorrhoids