چکیده (انگلیسی):

Aim: The prevalence of symptomatic hemorrhoidal disease is a common disease
that usually needs surgery for treatment. Although conservative treatment is often enough
for early stages, late stage disease usually needs surgical treatment. The most common and
effective approaches used for conventional surgical treatment are harmonic scalpel (HS)
and Ferguson’s with electrocautery hemorrhoidectomy (FEH). We aimed to use the HS device
for hemorrhoidectomy in Grade III and Grade IV hemorrhoids and compare our results with FEH
Materials and methods: Enrolled into the study were 151 patients who were operated for
symptomatic Grade IIIeIV hemorrhoids. Patients were randomized into FEH and HS groups.
The present review focused on comparing HS hemorrhoidectomy versus FEH with regards to
operating time, postoperative pain, duration of disease, number of issued analgesics, length
of hospital stay, time to return to normal activity, and postoperative complications.
Results: The mean ages of patients who underwent HS and FEH were 34.1
9.2 years and
33.7
8.4 years, respectively. The average postoperative stay in the HS group was
1.0
0.1 days and in the FEH group was 1.2
0.4 (p Z 0.001). The time of return to normal
activity was less for the HS groups than for the FEH groups (10.6
2.1 days vs. 16.0
6.3
days; p Z 0.001). The mean operating time of the HS and FEH groups was 16.8
4.1 minutes
and 25.5
7.7 minutes, respectively (p Z 0.001). The total analgesic doses for
the HS group were 790
206 mg, 619
234 mg, and 30
99 mg, and for the FEH group
were 1096
194 mg, 1000
259 mg, and 40
0 mg for postoperative Day 1, Day 7, and
Day 28, respectively. There was no significant difference between the HS group and the
FEH group in the terms of the number of excised hemorrhoid masses (2.0
0.6 vs.
1.88
0.6).
Conclusion: HS hemorrhoidectomy is safe and effective, causes less blood loss and postoperative
pain, and fewer complications compared to FEH.