Vol. 9, Issue 1, Part B (2025)

Background: Hemorrhoidectomy remains the gold standard treatment for grade III internal hemorrhoids, particularly the Milligan-Morgan open hemorrhoidectomy, due to its low recurrence rate. However, post-operative pain remains a major issue. To minimize pain, alternative techniques such as stapled hemorrhoidopexy have been introduced. Despite its potential advantages, the comparison of post-operative pain between these two surgical techniques remains controversial. 
Objective: This study aims to compare post-operative pain between stapled hemorrhoidopexy and open hemorrhoidectomy in patients with grade III internal hemorrhoids. 
Methods: A retrospective cohort study was conducted at Dr. M. Djamil Hospital and Yos Sudarso Hospital, Padang, between January and November 2024. Patients diagnosed with grade III internal hemorrhoids who underwent either open hemorrhoidectomy or stapled hemorrhoidopexy were included in the study. Post-operative pain was assessed using the Visual Analog Scale (VAS), and statistical analysis was performed to compare pain scores between the two groups. 
Results: A total of 22 patients were analyzed, with 11 undergoing open hemorrhoidectomy and 11 undergoing stapled hemorrhoidopexy. Patients in the open hemorrhoidectomy group reported moderate to severe post-operative pain, whereas those in the stapled hemorrhoidopexy group reported mild to moderate pain. The mean VAS score was significantly lower in the stapled hemorrhoidopexy group than in the open hemorrhoidectomy group (3.91±0.83 vs. 5.45±0.82, p=0.001). 
Conclusion: Stapled hemorrhoidopexy resulted in significantly lower post-operative pain compared to open hemorrhoidectomy in grade III internal hemorrhoid patients. Given its advantages, stapled hemorrhoidopexy may be a preferable alternative for pain reduction. However, further studies are required to evaluate long-term clinical outcomes.