Stapled versus harmonic scalpel hemorrhoidectomy in management of third- and fourth-degree hemorrhoids

Mohamed, Ahmed K.; Saad, Khaled M.; Mansour, Mohamed I.; Sallam, Ahmed M.; Habib, Fady M.

doi:10.4103/ejs.ejs_321_22

Stapled versus harmonic scalpel hemorrhoidectomy in management of third- and fourth-degree hemorrhoids

Authors

Abstract

Background
The ideal surgical technique for hemorrhoidectomy is still unknown, so new techniques like stapled hemorrhoidectomy (SH) and harmonic scalpel hemorrhoidectomy (HSH) are needed to be discussed. The current study’s objective was to compare the results of HSH with SH.
Patients and methods
A prospective randomized clinical trial involving 28 patients with grades III–IV hemorrhoids. Patients were randomized into two groups: group I (SH method): 14 patients underwent hemorrhoidectomy. Group II (HSH method): 14 patients underwent hemorrhoidectomy.
Results
There was no statistically significant difference in the distribution of age between the groups (31.78 9.29 and 29.35 9.10) or the distribution of sex. There was little variation between the groups, and the majority were grade III patients. There is no statistical difference between the study groups in terms of comorbidities. Regarding surgery time or blood loss, there was no statistical difference between the groups. Additionally, extra-analgesia was strongly connected with HSH group and pain was much less among SH group. Hospital stay duration and recovery time were both statistically shorter in the SH group. The cost of surgery was much higher for HSH group.
Conclusion
Because it is associated with reduced postoperative discomfort and an earlier return to work, stapled hemorrhoidopexy offers better outcomes and patient satisfaction than HSH.

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