HARMONIC SCALPEL® VERSUS CONVENTIONAL DIATHERMY HAEMORRHOIDECTOMY; GAIN OR PAIN? | ||||
| The Egyptian Journal of Surgery | ||||
| Article 4, Volume 30, Issue 3, July 2011, Page 111-118 PDF (1.22 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejsur.2011.367357 | ||||
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| Authors | ||||
| Waleed Omar; Sabry Mahmoud* ; Mohamed Farid | ||||
| General Surgery Department, Colorectal Surgery Unit, Faculty of Medicine, Mansoura University, Egypt | ||||
| Abstract | ||||
| Aim: Postoperative pain is the most distressing drawbacks of surgical hemorrhoidectomy. We will compare harmonic scalpel hemorrhoidectomy with diathermy hemorrhoidectomy as regard postoperative pain, analgesic requirements duration of healing and other complications. Methods: Seventy-two patients having symptomatic grade III & IV hemorrhoids were randomly classified into two groups; the first group (group I) (36 patients) were operated upon using harmonic scalpel® and the second group (group II) (36 patients) were operated upon using conventional monopolar diathermy. Operative time & postoperative pain severity and analgesic requirements were recorded 6, 12, 24, 48 hours, 7, 14 and 28 days. Incidence of bleeding and wound infection was recorded in 1, 2, 3 & 4 weeks. The patients were followed up for 6 months where late complications as delayed wound healing, anal stenosis, incontinence and persistant pain, all were recorded in both groups. Results: Operative time was significantly shorter in harmonic scalpel group, also, there was no blood loss. Postoperatively, pain scoring was significantly lower in group I and subsequently daily analgesic requirements. Healing was faster in first group. Secondary infection and bleeding occurred in second group with no incidence in first group, also, temporary minor fecal incontinence occurred in second group only. Conclusion: Harmonic scalpel hemorrhoidectomy can be used safely for treatment of grade III & IV hemorrhoids and is better in most of aspects than conventional diathermy. Its cost is overcome by shorter operation, rapid healing and early return to work. | ||||
| Keywords | ||||
| Hemorrhoids; hemorrhoidectomy; harmonic scalpel®; diathermy | ||||
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