Abstract
Objectives: To compare the efficacy of 0.2% glyceryl trinitrate ointment versus
internal sphincterotomy after hemorrhoidectomy. Study Design: Randomized Controlled Trial.
Setting: Department of Surgery Unit III, at Lahore General Hospital, Lahore. Period: 6 months
(August 2017 to February 2018). Material & Methods: The OPD of the Department of Surgery
included 124 patients who satisfied the inclusion criteria. There were two groups of patients,
Group A and Group B. Group-A was told to use gloved finger three times daily for 0.2 percent
GTN ointment topically. For Group B, lateral internal sphincterotomy was performed as day care
procedure. On visit, patients were assessed for pain relief by using VAS. All data was collected
using a pre-designed (attached) proforma. In SPSS v23.0 the data were input and analyzed. It
was stratified for age, sex, disease duration and hemorrhoid stage. The effectiveness of both
groups was compared by using a p-value of 0.05 as significant for a chi-square test. Results:
Male predominance; in group-A, 41(66.1%) patients were male and 21(33.9%) were female,
while in group-B, 52(83.9%) patients were male and 10(16.1%) were females. Efficacy was
found in 11(17.7%) patients in group-A (0.2% GTN) while in 25(40.3%) patients in group-B
(Internal sphincterotomy) with p-value of 0.006 which is statistically significant. Conclusion:
Open hemorrhoidectomy internal sphincterotomy is an effective method to reduce pain after
hemorrhoidectomy in contrast to Glyceryl Trinitrate (GTN) topical cream of 0.2 percent.
Muhammad Arif, Sabih Nofal, Ahsan Khan , Mariam Tariq Awana, Anum Arif. (2020) Comparison of efficacy of internal sphincterotomy versus topical 0.2 % glyceryl trinitrate ointment after hemorrhoidectomy., The Professional Medical Journal, Volume 27, Issue 12.
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