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ABSTRACT
Hemorrhoid disease is the most common reason patients seek evaluation by a colon and rectal surgeon. The majority of hemorrhoids can be managed nonoperatively with medical management or as day care procedures. Even though Milligan Morgan Hemorrhoidectomy(MMH) & Minimal Invasive Procedure for Hemorrhoid (MIPH) is the gold standard for hemorrhoids, but newer techniques like INFRA-RED Coagulation(IRC) for 1st, 2nd & 3rd degree hemorrhoids are showing promising results because of minimal complications, ease of procedure and a day care procedure most of the time. Besides that many patients are not ready for a definite surgical procedure and they can be benefitted by IRC.
Keywords: Hemorrhoids, Infra-red coagulation (IRC), Milligan-Morgan Hemorrhoidectomy (MMH), Minimal Invasive Procedure
INTRODUCTION
The word "hemorrhoids' is derived from the greek word hemorrhoides meaning bleeding, which is most prominent symptom in majority of cases, the term is also used interchangeably with another term 'piles' which is a derivation of the latin word pila meaning a ball1. Haemorrhoids are classified according to their place in anal canal into internal & external in relation to dentate line. Mixed or combined hemorrhoids are defined as the presence of both internal & external hemorrhoids.
Open hemorrhoidectomy, also known as excision & ligation was originated by Frederick Salmon 2 in 1830s. Milligan et al3 modified and popularized the technique which is now widely used known as Milligan Morgan hemorrhoidectomy.
Longo's technique, commonly referred to as the stapled hemorrhoidectomy or stapled hemorrhoidopexy aka MIPH is another standard operative technique but it is costly and has been associated with a number of serious complications, including anastomotic dehiscence necessitating colostomy, rectal perforation, severe pelvic infection, and acute rectal obstruction and therefore training before use is strongly recommended.
Among the newer technique for treatment of hemorrhoids is Infra-Red Coagulation4, it utilizes infrared radiation generated by tungsten halogen lamp applied to hemorrhoidal tissue through a solid quartz light guide. In the infrared coagulator light is converted to heat which coagulates tissue protein and evaporates water from cells leading to inflammation, eschar formation and eventual scarring which fixates the tissue and stops the bleeding5.
AIMS & OBJECTIVES
1) To study the comparative effects of IRC and Milligan-Morgan hemorrhoidectomy(MMH) for 1st, 2nd, 3rd degree Hemorrhoids.
2) To follow these patients post-IRC for 3 months.