Evaluation of two hemorrhoidectomy techniques: Harmonic scalpel and Ferguson's with electrocautery

Aim: The prevalence of symptomatic hemorrhoidal disease is a common disease that usually needs surgery for treatment. Although conservative treatment is often enough for early stages, late stage disease usually needs surgical treatment. The most common and effective approaches used for conventional surgical treatment are harmonic scalpel (HS) and Ferguson's with electrocautery hennorrhoidectomy (FEFI). We aimed to use the HS device for hemorrhoidectomy in Grade Ill and Grade IV hemorrhoids and compare our results with FEH Materials and methods: Enrolled into the study were 151 patients who were operated for symptomatic Grade III IV hemorrhoids. Patients were randomized into FEH and HS groups. The present review focused on comparing HS hemorrhoidectomy versus FEH with regards to operating time, postoperative pain, duration of disease, number of issued analgesics, length of hospital stay, time to return to normal activity, and postoperative complications. Results: The mean ages of patients who underwent HS and FEH were 34.1 +/- 9.2 years and 33.7 +/- 8.4 years, respectively. The average postoperative stay in the HS group was 1.0 +/- 0.1 days and in the FEH group was 1.2 +/- 0.4 (p = 0.001). The time of return to normal activity was less for the HS groups than for the FEFI groups (10.6 +/- 2.1 days vs. 16.0 +/- 6.3 days; p = 0.001). The mean operating time of the HS and FEH groups was 16.8 +/- 4.1 minutes and 25.5 +/- 7.7 minutes, respectively (p = 0.001). The total analgesic doses for the HS group were 790 +/- 206 mg, 619 +/- 234 mg, and 30 +/- 99 mg, and for the FEH group were 1096 +/- 194 mg, 1000 +/- 259 mg, and 40 +/- 0 mg for postoperative Day 1, Day 7, and Day 28, respectively. There was no significant difference between the HS group and the FEFI group in the terms of the number of excised hemorrhoid masses (2.0 +/- 0.6 vs. 1.88 +/- 0.6). Conclusion: HS hemorrhoidectomy is safe and effective, causes less blood loss and postoperative pain, and fewer complications compared to FEM. Copyright (c) 2013, Asian Surgical Association. Published by Elsevier Taiwan LLC. All rights reserved.