Randomised Clinical Trial of Harmonic Scalpel Haemorrhoidectomy Versus Stapled Haemorrhoidopexy in grade III / IV Haemorrhoids
Indian Journal of Surgery - Trang 1-4 - 2023
Tóm tắt
This study aimed to compare the efficacy of Harmonic Scalpel Haemorrhoidectomy versus Stapled Haemorrhoidopexy in the management of grade 3 and grade 4 haemorrhoids. This comparison factored in post-operative pain, operating time, intra-operative bleeding, post-operative complications, and recurrence rates. The aim was to aid the decision-making process to determine the course of treatment to be offered to patients. Over the course of 18-months, it was a randomised control trial. A total of 42 patients (21 in each arm) were studied to observe the outcomes of procedures in treating grade III / IV haemorrhoids. The only statistically significant difference was in the post-operative pain, as calculated using Visual Analog Scale, with patients undergoing Stapled Haemorrhoidopexy experiencing lesser pain, thus translating to early hospital discharge and return to work. In conclusion, Stapled Haemorrhoidopexy can be regarded as a better modality with reduced post-operative pain as compared to Harmonic Scalpel Haemorrhoidectomy.
Tài liệu tham khảo
(1968) Surgery of the anus, rectum and colon. By J. C. Goligher, Ch.M., F.R.C.S., Professor of Surgery, University of Leeds. Second edition. 9¾ × 7 in. Pp. 1120, with 630 illustrations plus 6 pages of color plates. 1967. London: Baillière, Tindall, and Cassell Ltd. £10 10s. Br J Sur 55(5):98. https://doi.org/10.1002/bjs.1800550522
Hippocrates, Adams F (1849) The genuine works of Hippocrates. Sydenham Society, p 825
Person JD, Arderne P (1968) Treatises of fistula in ano: Hæmorrhoids, and Clysters: John Arderne. Taylor & Francis. Oxford Univ. Press, London, p 68
Thomson W (1975) The nature of haemorrhoids. Br J Surg 62(7):542–552
Lohsiriwat V (2012) Haemorrhoids: From basic pathophysiology to clinical management. World J Gastroenterol 18(17):2009–2017
Eastman PF, Applebaum IA (1969) Critical evaluation of internal haemorrhoidal ligation as an outpatient procedure. Amer J Proctol 20:201–209
MacRae HM, McLeod RS (1995) Comparison of haemorrhoid treatment modalities: a meta-analysis. Dis Colon Rectum 38:687–694
Mushaya C, Caleo P, Bartlett L, Buettner P, Ho Y (2014) Harmonic scalpel compared with conventional excisional haemorrhoidectomy: a meta-analysis of randomised controlled trials. Tech Coloproctol 18(11):1009–1016
Chung CC, Ha JP, Tai YP, Tsang WW, Li MK (2002) Double- blind, randomised trial comparing Harmonic Scalpel™ haemorrhoidectomy, bipolar scissors haemorrhoidectomy and scissors excision: ligation technique. Dis Colon Rectum 45:789–794
Longo A (1998) Treatment of haemorrhoid disease by reduction of mucosa and haemorrhoidal prolapse with a circular suturing device. In: 6th World Congress of Endoscopic Surgery, Rome
Rowsell M, Bello M, Hemingway DM (2000) Circumferential mucosectomy (stapled haemorrhoidectomy) versus conventional haemorrhoidectomy: randomised controlled trial. Lancet 355:779–781
Mehigan BJ, Monson JR, Hartley JF (2000) Stapling procedure for haemorrhoids versus Milligan-Morgan haemorrhoidectomy: randomised controlled trial. Lancet 355:782–785
Ho YH, Cheong WK, Tsang C et al (2000) Stapled haemorrhoidectomy—cost and effectiveness. Randomised, controlled trial including incontinence scoring, anorectal manometry, and endoanal ultrasound assessments at up to three months. Dis Colon Rectum 43:1666–1675
Helmy MA (2000) Stapling procedure for haemorrhoids versus conventional haemorrhoidectomy. J Egypt Soc Parasitol 30:951–958
Khalil KH, O’Bichere A, Sellu D (2000) Randomized clinical trial of sutured versus stapled closed haemorrhoidectomy. Br J Surg 87:1352–1355
Singer M, Abcarian H (2004) Stapled haemorrhoidopexy: the argument for usage. Clin Colon Rectal Surg 17(2):131–142. https://doi.org/10.1055/s-2004-828660
Khan S, Pawlak SE, Eggenberger JC et al (2001) Surgical treatment of haemorrhoids: prospective, randomised trial comparing closed excisional haemorrhoidectomy and the Harmonic Scalpel technique of excisional haemorrhoidectomy. Dis Colon Rectum 44:845–849
Sutherland LM, Burchard AK, Matsuda K, Sweeney JL, Bokey EL, Childs PA, Roberts AK, Waxman BP, Maddern GJ (2002) A systematic review of stapled haemorrhoidectomy. Arch Surg 137(12):1395–406. https://doi.org/10.1001/archsurg.137.12.1395. (discussion 1407)