Background: Hemorrhoids, or anorectal vascular cushions, become symptomatic when they enlarge or prolapse, causing bleeding, mucous discharge, itching, pain, and prolapse. The objective of this study is to assess the effectiveness of the Chivate procedure compared to Longo's technique, focusing on key outcomes such as operative time, post-operative pain, complication rates, return to normal activity, and recurrence. The Chivate procedure, with its minimally invasive approach, aims to enhance patient recovery and reduce recurrence by precisely restoring the anatomical structure of the hemorrhoidal cushions. Material And Methods: In this prospective comparative study, conducted at Darbhanga Medical College from August 2023 to July 2024, a total of 50 patients with clinically diagnosed second, third, or fourth-degree haemorrhoids were enrolled and surgically treated. The patients were randomized into two groups: Group A(n=25), in which Chivate's procedure was performed, and Group B (n=25), in which Longo's Stapled Hemorrhoidopexy was conducted. Postoperative assessments were carried out at 12, 24, and 48 hours to monitor early recovery metrics, while follow-up evaluations at 2, 4, and 8 weeks, extending up to 6 months, enabled a systematic comparison of both procedures concerning operative time, postoperative pain, complication rates, recovery to normal activities, and recurrence rates. Statistical Analysis: Data analysis was conducted using standard statistical methods with SPSS software (version 200). Comparative evaluations between the two groups were performed using the Chi-Square Test, with statistical significance defined at a P-value of <0.05. Results: The Chivate technique (Suture Rectopexy) demonstrated reduced postoperative pain, as measured by the Visual Analogue Scale, along with shorter operative times, fewer days of hospitalization, and a quicker return to normal activities. The Longo technique (Stapled Hemorrhoidopexy) yielded similar results in these areas. While there were no significant differences in postoperative complications between the two procedures, the recurrence rate was lower in the Chivate technique. Specifically, 7 cases of recurrence were noted following Longo's procedure, compared to only 3 cases after the Chivate procedure. Conclusion: Several surgical techniques are employed in the management of haemorrhoids. However, our study indicates that the Chivate procedure (Suture Rectopexy) offers superior clinical outcomes compared to the Longo procedure (Stapled Hemorrhoidopexy), particularly in terms of minimizing recurrence rates and achieving better aesthetic results. While both procedures exhibit comparable postoperative recovery profiles, the Chivate technique demonstrates a significant advantage in reducing recurrence, making it a more efficacious option for the long-term management of hemorrhoidal disease.
Sah et al. (Tue,) studied this question.