HAEMORRHOIDECTOMY;

OUTCOME USING HARMONIC SCALPEL VERSUS CONVENTIONAL CLOSED HAEMORRHOIDECTOMY

Abstract

Haemorrhoids are one of the most common anorectal disorders. Internal
haemorrhoids are symptomatic anal cushions and characteristically lie in the 3, 7 and 11 o’clock
position whereas external haemorrhoids relate to venous channels of the inferior haemorrhoidal
plexus. Objectives: To compare the outcome of haemorrhoidectomy using harmonic scalpel
versus conventional closed haemorrhoidectomy. Study Design: Randomized control trial.
Setting: Department of Surgical unit II, Jinnah Hospital, Lahore. Period: Six months from 25th
December 2014 to 24th June 2015. Methodology: A total of 140 patients were included in
this study. Patients were divided in two groups A & B. In Group A, (70 patients) conventional
haemorrhoidectomy was performed by the Ferguson Technique (closed technique) whereas
in Group B, (70 patients) suture less closed haemorrhoidectomy was performed by using the
harmonic scalpel. Results: The mean age of the patients in group A was 43.3±8.2 years and
in group B was 42.3±7.3 years. The mean time for surgery in group A was 23.8±4.2 minutes
and in group B was 8.5±3.6 minutes. The mean pain score in group A was 5.3±1.8 VAS and
in group B was 3.9±1.9 VAS. In group A, less than 1 day postoperative hospital stay was in 62
(88.6%) patients and in group B, it was in 66 (94.3%) patients. Conclusions: It is concluded
from this study that haemorrhoidectomy by harmonic scalpel results in decrease in operation
time and less postoperative pain although there is not much significant difference in less than 1
day hospital stay as compared to the conventional closed haemorrhidectomy technique.