RT Journal Article
SR Electronic
T1 A comparison of different hemorrhoidectomy procedures.
JF Saudi Medical Journal
JO Saudi Med J
FD Prince Sultan Military Medical City
SP 1264
OP 1269
VO 29
IS 9
A1 Ozer, Mustafa T.
A1 Yigit, Taner
A1 Uzar, Ali I.
A1 Mentes, Oner
A1 Harlak, Ali
A1 Kilic, Selim
A1 Cosar, Ahmet
A1 Arslan, Ismail
A1 Tufan, Turgut
YR 2008
UL http://smj.org.sa/content/29/9/1264.abstract
AB OBJECTIVES To evaluate the pain level, analgesic consumption, operation time, bleeding and early complications after open and closed hemorrhoidectomy using a harmonic scalpel (HS) and classical methods. METHODS Between January 2005 and January 2006, 87 patients with grade III-IV hemorrhoids, admitted in General Surgery Clinic, Gulhane Military Medical Academy, Ankara, Turkey were enrolled in the study. They were randomized into open HS (n=22), closed HS (n=22), Miligan Morgan (n=22), and Ferguson (n=21) hemorrhoidectomy. Patients were evaluated for postoperative pain, painkiller consumption, bleeding and operation time. RESULTS Bleeding volume was significantly lower in Groups I-II (p<0.001). Operation time was significantly shorter in Group I (p<0.001). Postoperative pain and pain at the time of first defecation, was significantly lower in Groups I-III (p<0.001) compared with the other 2 groups and lower during days 2-6 in Group I compared to the Group III (p<0.004). Visual Analogue Scale results were similar in Groups II and IV. Analgesic consumption in Groups I-III was significantly lower than Groups II-IV (p<0.001). Oral analgesic consumption during 2-5 postoperative days was lower in Group I than in Group III (p<0.007) and similar in closed hemorrhoidectomy group. CONCLUSIONS The use of HS in hemorrhoidectomy reduces postoperative pain, analgesic consumption, operation time, and bleeding. Harmonic scalpel hemorrhoidectomy is an effective, comfortable, and safe procedure. Use of suture in hemorrhoidectomy is a major cause of postoperative pain.