Title: A Prospective Study to determine the outcome and efficacy of Harmonic scalpel Hemorrhoidectomy
Authors: Thakur D S, Joshi H, Somashekar U, Kothari R, Kumar V, Sharma D
DOI: https://dx.doi.org/10.18535/jmscr/v8i2.148
Abstract
Aims and Objectives: The aim of the present work is to determine the outcome and efficacy of Harmonic scalpel hemorrhoidectomy (HSH) for grade III and IV hemorrhoids in terms of Operating time, Post operative pain, Post operative stay and Post operative complications.
Methods: Prospective study of 30 patient for grade III and IV hemorrhoids was done from October 2017 to 31st August 2019 at department of general surgery N.S.C.B Medical College and Hospital, Jabalpur. All surgeries done under saddle block. A follow up examination was conducted for minimum period of 3 months.
Results: Out of 30 patients 7 female and 23 male patients were treated with HSH. The mean age of patients were 46.17 years. The average operative time was 19.20±2.14min.VAS pain score on postoperative Day 1, Week 1, Week 3, Week 6 were 4.77±0.94 , 2.83±0.75 , 0.20±0.41 and 0.The average postoperative stay was 1.13 ±0.43 days. the incidence of post operative hemorrhage was low and 1 of 30 cases i.e. 3.3% and no recurrence or fecal incontinence, stenosis/stricture, and anal abscess was found after 3 months of follow up.
Conclusion: The present study shows that HSH is safe, effective, with less complication rate.
References
- Johnson JF, Sonnenberg A. The prevalence of hemorrhoids and chronic constipation: an epidemiological study. Gastroen- terology. 1990; 98(2): 380.386.
- Hemorrhoids Eksperimental’ Naia i Kliniches- kaia Gastroenterologiia.2002; 4: 93-96.
- MacRae HM, McLeod RS. Comparison of Hemorrhoid- al Treatment Modalities.A meta-analysis. Dis Colon Rectum. 1995; 38(7): 687-694.
- Longo A. Treatment of haemorrhoidal disease by reduction of mucosa and haemorrhoidal prolapse with a circular stapling device: a new procedure.
- Thompson WH. The nature of hemorrhoids. Br J Surg1975;62:542–52.
- Sayfan J, Becker A, Koltun L. Sutureless closed hemorrhoidectomy: a new technique. Ann Surg. 2001;234:21e24.
- Prospective, randomized trial comparing pain and clinical function after conventional scissors excision/ligation vs. diathermy excision without ligation for symptomatic prolapsed hemorrhoids. Seow- Choen F, Ho YH, Ang HG, GohHSDis Colon Rectum. 1992 Dec; 35(12):1165-9.
- Tech Coloproctol. 2002 Sep;6(2):89-92
- International Surgery Journal Thiyagarajan A et al. Int Surg J. 2017 Sep;4(9):3007-3014.
- Ann Coloproctol. 2016 Jun; 32(3): 111 116.
- Milito G, Cadeddu F. Tips and tricks: haemorrhoidectomy with Liga Sure. Tech Coloproctol. 2009;13(4):317-20
- Bulus H, Tas A, Coskun A, Kucukazman M. Evaluation of two hemorrhoidectomy techniques: harmonic scalpel and Ferguson's with electrocautery. Asian J Surg. 2014;37:20–23.
- Asian journal of surgery (2014)37 ,20-23.