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Revista Mexicana de Coloproctología Enfermedades del Ano, Recto y Colon

2010, Number 1-3

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Rev Mex Coloproctol 2010; 16 (1-3)

Comparative study between hemorrhoidectomy using harmonic scalpel and electrocautery hemorrhoidectomy

Toro G, Guillén TY, Bravo P, Sardiñas C

Language: Spanish
References: 40
Page: 15-19
PDF size: 185.41 Kb.


ABSTRACT

Methods: We studied 30 patients with hemorrhoidal disease (grade II-IV) who assist to the Coloproctology Unit at the Caracas Universitary Hospital between March 2008 to August 2008. Patients were divided in two groups: Group A: Electric scalpel (EB), Group B: Harmonic scalpel (BA). Results: Statistic Significance was p ‹ 0.005. Cause of consultation was Rectoragy 52%; main hemorrhoidal disease: Thrombosis 37%; Main preoperative symptom: Ocassional bleeding 47%. 24 hours postoperative bleeding: p = 0.05 (EB: 53%, BA: 73%). 8th week occasional anal pruritus p = 0.05 (EB: 7%, BA: 20%). 8th week occasional secretion EB: 13%, BA: 33%). Pain was always higher in the Harmonic group until 2nd week (p = 0.05). Main cicatrization time was 22.9 days (EB) and 37.5 days (BA) (p = 00027). Upload to normal activities was at 18.3 days (EB) and 29.2 days (BA) p = 0.00026. Surgical time was 6.3 minutes (EB) and 2.9 minutes (BA) p = 0.0000000. Summary: Open Hemorrhoidectomy with the Electric scalpel is an easy to perform technique with improvements in terms of postoperative pain, bleeding, pruritus, fluid, cicatrization, upload to normal activities and quality of life.


REFERENCES

  1. Goligher JC. Cirugía del ano, recto y colon. 5ta Ed. España: Salvat; 1980: 97-140.

  2. Sardiñas C. Proctología para cirujanos generales. 1a ed. Caracas: DISINLIMED; 2002: 78-93.

  3. Marti MC. The past and future of proctology. Schweiz Rundsch Med Prax 1990; 79: 889-91.

  4. Johanson, JF, Sonnenberg A. The prevalence of hemorrhoids and chronic constipation: An epidemiologic study. Gastroenterology 1990: 380-386.

  5. MacRae HM, McLeod RS. Comparison of hemorrhoidal treatment modalities: A meta-analysis. Dis Colon Rectum 1995: 687-694.

  6. Bleday R, Pena JP, Rothenberger DA, Goldberg SM, Buls JG. Symptomatic hemorrhoids: current incidence and complications of operative therapy. Dis Colon Rectum 1992: 477-481.

  7. Walker GL, Nigro ND. Postoperative anorectal hemorrhage. Surg Clin North Am 1959: 1655-60.

  8. Milson JW, Mazier WP. Classification and management of post-surgical anal stenosis. Surg Gynecol Obstet 1986: 1-5.

  9. Milligan ET, Morgan CN, Jones LE, Officer R. Surgical anatomy of the anal canal and the operative treatment of haemorrhoids. Lancet 1937: 119-24.

  10. Ferguson JA, Heaton JR. Closed hemorrhoidectomy. Dis Colon Rectum 1959: 176-179.

  11. Golighten J, Graham NG, Cleark CG, De Dohmal IT, Giles G. The value of stretching the anal sphincter in the relief of post-haemorrhoidectomy pain. Br J Surg 1969: 859-61.

  12. Armstrong DN, Frankum C, Schertzer ME, Ambroze WL, Orangio GR. Harmonic scalpel hemorrhoidectomy: five hundred consecutive cases. Dis Colon Rectum 2002: 354-359.

  13. Khan S, Pawlak SE, Eggenberger JC, Lee CS, Szilagy EJ, Wu JS, Margolin M. Surgical treatment of hemorrhoids: prospective, randomized trial comparing closed excisional hemorrhoidectomy and the Harmonic Scalpel® technique of excisional hemorrhoidectomy. Dis Colon Rectum 2001: 845-849.

  14. Ramadan E, Vishne T, Dreznik Z. Harmonic scalpel method. Tech Coloproctol 2002: 89-92.

  15. Jane JY, Tan MBBS, Seow-Choen FRCS. Prospective, randomized trial comparing diathermy and harmonic scalpel hemorrhoidectomy. Dis Colon Rectum 2001: 677-679.

  16. Graham-Stewart CW. What causes haemorrhoids? A new theory of etiology. Dis Colon Rect 1963; 6: 333.

  17. Miles WE. Rectal Surgery. London: Cassell. 1939.

  18. Otto P, Otto JU. Hemorrhoidal diseases. Schweiz Rundsch Med Prax 1994; 83: 1225-8.

  19. Aminoff I. Caution: Hemorrhoidal prolapse. Harefuah 1999; 136: 993-6.

  20. Parks AG. De haemorrhoids. Guy´s Hosp Rep 1955: 104-135.

  21. Allingham W, Allingham HW. The diagnosis and treatment of diseases of the rectum. 7th ed. London: Bailliere. 1901.

  22. Anderson HG. The after results of the operative treatment of haemorrhoids. Brit Med J 1909; 2: 1276.

  23. Milligan ETC. In discussion on the complications of operations for piles. Proc Roy Soc Med 1930; 23: 706.

  24. Gabriel WB. The principles and practice of rectal surgery. 4th ed. London: Lewis. 1948.

  25. Lockhart-Mummery JP. Diseases of the rectum and colon. 2nd ed. London: Bailliere. 1934.

  26. Miles WE. Observations upon internal piles. Surg Gynec Obstet 1919; 29: 496.

  27. Petit JL. Traité des maladies chirurgicales et des operations qui leer conviennent. Paris: T.F. Didot. 1774; 2: 137.

  28. Cooper S. A dictionary of practical surgery. London: Longmans. 1809.

  29. Barron J. Office ligation of internal haemorrhoids. Amer J Surg 1963; 105: 563.

  30. Blaisdell PC. (1958). Prevention of massive haemorrhage secondary to haemorrhoidectomy. Surg Gynec Obstet 1958; 106: 485.

  31. Mitchell AB. (1903). A simple method of operating on piles. Brit Med J 1903; 1: 482.

  32. Buls JG, Goldberg SM. MODEM management of hemorrhoids. Surg Clin North Am 1978; 58: 469-78.

  33. Nieves PM, Perez J, Suarez JA. Hemorrhoidectomy-how I do it: experience with the St. Mark´s Hospital technique for emergency hemorrhoidectomy. Dis Colon Rectum 1977; 20: 197-201.

  34. Cusack JW. Dublin Quarterly J. Med Sci (n.s.), 1846; 2: 562.

  35. McCarus SD. Physiologic mechanism of the ultrasonically activated scalpel. J Am Assoc Gynecol Laparosc 1996; 3: 601-8.

  36. Msika S, Deroide G, Kianmanesh R et al. Harmonic scalpel in laparoscopic colorectal surgery. Dis Colon Rectum 2001; 44: 432-436.

  37. Kusunoki M, Shoji Y, Yanagi H, Ikeuchi H, Noda M, Yamamura T. Current trends in restorative poctocolectomy: introduction of an ultrasonically activated scalpel. Dis Colon Rectum 1999; 42: 1349-52.

  38. Maruta F, Sugiyama A, Matsushita K, Ishida K, Ikeno T, Shimizu F et al. Use of the harmonic scalpel in open abdominoperineal surgery for rectal carcinoma. Dis Colon Rectum 1999; 42: 540-2.

  39. Seow-Choen F, Ho YH, Ang HG, Goh HS. Prospective, randomized trial comparing pain and clinical function after conventional scissors excision/ligation versus diathermy excision without ligation for symptomatic prolapsed hemorrhoids. Dis Colon Rectum 1992; 35: 1165-9.

  40. Armstrong DN, Ambroze WL, Schertzer ME, Orangio GR. Harmonic scalpel vs electrocautery hemorrhoidectomy: a prospective evaluation. Dis Colon Rectum 2001; 44:558–564.




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