Comparison of Postoperative Complications between Conventional Diathermy Haemorrhoidectomy and Harmonic Scalpel Haemorrhoidectomy
Amr Abd El Raouf Ali Abd El Naser, Kamal Mamdouh Kamal El Said, Abd El Rahman Mohamed El Ghandour, Mennat Allah Muhammad Youssuf Ahmad- General Medicine
Abstract
Background
For symptomatic grade III and IV haemorrhoids, some form of hemorrhoidectomy remains the accepted modality of treatment. The traditional methods like the Milligan-Morgan method and the Ferguson‟s method have been in practice for more than half a century. Recently we acquired the Harmonic system. It is an ultrasonic dependent technology, using waves to both seal and cut vessels and tissues in a hypothermic condition, now widely used for hemorrhoidectomy. This study will give a comprehensive overview on differences between conventional diathermy haemorrhoidectomy and Harmonic scalpel haemorrhoidectomy focusing on post-operative complications mainly postoperative pain, bleeding, anal stenosis and peri-anal fistulae occurrence.
Objective
To compere between conventional diathermy hemorrhoidectomy and Harmonic scalpel hemorrhoidectomy as regards post-operative pain, bleeding, anal stenosis and peri-anal fistula occurrence.
Patients and Methods
It is a prospective study conducted over 40 patients with grade III and IV hemorrhoids, randomly divided into two groups to compare between conventional diathermy hemorrhoidectomy, Harmonic scalpel hemorrhoidectomy as regards post-operative pain, bleeding, anal stenosis and peri-anal fistula occurrence.
Results
An overall favorable trend exists toward Harmonic scalpel hemorrhoidectomy in all parameters of the current study, in another word, the postoperative complications mainly pain, bleeding, anal stenosis and peri-anal fistula occurrence was much lesser in the Harmonic group.
Conclusion
Harmonic scalpel hemorrhoidectomy is a sutureless, hemorrhoidectomy technique dependent on an ultrasonic unit to achieve vessel and tissue sealing. It is safe and effective, has less blood loss, postoperative pain, bleeding, anal stenosis and perianal fistula occurrence compared to conventional diathermy hemorrhoidectomy.