Stapled Hemorrhoidopexy vs. Harmonic Scalpel™ Hemorrhoidectomy: A Randomized Trial

Chung, C. C.; Cheung, Hester Yui Shan; Chan, Eva Sze‐Wah; Kwok, Sui-Yi; Li, Michael K.W.

doi:10.1007/s10350-004-0918-z

“…The mean operative time in our study was 37.23 ± 6.287 in group A (Electrocautery) while in group B, it was 32.24 ± 7.334 minutes [Stapler (PPH Gun)]. This is comparable to the results by Chung CC et al (13) in which the mean operative time with Electrocautery is 36 ± 3 minutes and with Ultrasonic Harmonic Scalpel is 30 ± 4 minutes. In the study by Tsunoda et al (12) , median operative time was 16 (95% confidence interval: 14.6-18.2) minutes in electrocautery group while in harmonic scalpel group it was 31 minutes (95% confidence interval:28.1-35.3), with p-value ≤0.0001.…”

Section: Discussionsupporting

confidence: 80%

Untitled

2017

IAM

0

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Objective: To compare usage of electrocautery versus stapler in hemorrhoidectomy. Study Design: Randomized control trial. Sampling technique: Non-probability consecutive sample selection. Place and Duration of Study: Department of Surgery (surgical unit II) Bahawal Victoria Hospital Bahawalpur Pakistan, in 6months (from July 2014 to January 2015). Methodology: A total of 124 patients fulfilling the inclusion criteria undergoing procedures for hemorrhoids were randomly divided into group 'A' and 'B' treated by conventional haemorrhoidectomy & haemorrhidopexy respectively. Procedures were evaluated for operative time, intraoperative blood loss and postoperative pain. Results: There was a significant difference in mean operative time, mean intraoperative bleeding & post-operative pain among two groups. Mean operative time 37.23 ± 6.287 minutes in group A while in group B, it was 32.24 ± 7.334 minutes (p <0.009). Mean intraoperative blood loss in group A patients was 8.00 ± 3.539 ml while .in group B, it was 6.29 ± 3.271 ml (p < 0.049). Mean postoperative pain on VAS in group A was 5.34 ± 1.708 while it was 4.13 ± 1.76 in group B (P< 0.02). Conclusion: The Stapled Haemorrhoidopexy was found a better choice in term of less post-operative pain, intra-operative bleeding and operative time as compared to electrocautery Hemorrhoidectomy.

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“…Faecal urgency was reported after CH [35] in the postoperative period [35,37,41]. There was no difference at 12 months and beyond (OR 1.04; 95% CI: 0.36, 3.03; P = 0.94; five RCTs) [21,24,33,34,43].…”

Section: Complicationsmentioning

confidence: 99%

“…3) [12,22,[25][26][27][28]30,32,[35][36][37][38][39][40][41][42]. Significant heterogeneity was observed between studies (P = 0.003; I 2 = 57.8).…”

Section: Bleedingmentioning

confidence: 99%

Stapled haemorrhoidopexy for the treatment of haemorrhoids: a systematic review

Burch

¹

,

Epstein

²

,

Sari

³

et al. 2009

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Objective This systematic review aimed to evaluate the short-and long-term safety, efficacy and costs of stapled haemorrhoidopexy (SH) compared with conventional haemorrhoidectomy.Method We searched 26 electronic databases and websites for studies in any language up to July 2006. Inclusion criteria were predefined, and each stage of the review process was conducted in duplicate.Results Twenty-seven randomized controlled trials were included (n = 2279). All had some methodological flaws. Postoperatively, 19 trials (95%) reported less pain, 17 (89%) reported a shorter operating time, 14 (88%) a shorter hospital stay, and 14 (93%) a shorter convalescence time following SH. However, prolapse was significantly more common after SH (OR 3.38; 95% CI: 1.00, 11.47). In the longer term, prolapse was significantly more common after SH (OR 4.34; 95% CI: 1.67, 11.28) as was reintervention for prolapse (OR 6.78; 95% CI: 2.00, 23.00). There were no differences in the rate or type of complications. Conventional haemorrhoidectomy and SH had similar costs during the initial admission.Conclusion Compared with conventional haemorrhoidectomy, SH resulted in less postoperative pain, shorter operating time, a shorter hospital stay, and a shorter convalescence, but a higher rate of prolapse and reintervention for prolapse.

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“…The amount of intraoperative blood loss in my study was 8.000 ± 3.539 ml in Electrocautery group, while in Stapler Hemorrhoidopexy group; it was 6.29 ± 3.271 ml. In the study by Chung CC et al (13) , the amount of blood loss in Stapler group was 7 ± 3 ml while in Ultrasonic Harmonic Scalpel group; this was 10 ± 4 ml. In the study by Tsunoda et al (12) , reduced intraoperative blood loss was observed in the diathermy group; mean blood loss is 9 ± 3ml versus harmonic scalpel group, mean blood loss 7 ± 3 ml with p-value < 0.001.…”

Section: Discussionmentioning

confidence: 88%

Conventional Hemorrhoidectomy with Electrocautery Versus Stapled Hemorrhoidopexy for Treatment of Haemorrhoids

khan

¹

,

wabasa

²

2017

IAM

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Objective: To compare usage of electrocautery versus stapler in hemorrhoidectomy. Study Design: Randomized control trial. Sampling technique: Non-probability consecutive sample selection. Place and Duration of Study: Department of Surgery (surgical unit II) Bahawal Victoria Hospital Bahawalpur Pakistan, in 6months (from July 2014 to January 2015). Methodology: A total of 124 patients fulfilling the inclusion criteria undergoing procedures for hemorrhoids were randomly divided into group 'A' and 'B' treated by conventional haemorrhoidectomy & haemorrhidopexy respectively. Procedures were evaluated for operative time, intraoperative blood loss and postoperative pain. Results: There was a significant difference in mean operative time, mean intraoperative bleeding & post-operative pain among two groups. Mean operative time 37.23 ± 6.287 minutes in group A while in group B, it was 32.24 ± 7.334 minutes (p <0.009). Mean intraoperative blood loss in group A patients was 8.00 ± 3.539 ml while .in group B, it was 6.29 ± 3.271 ml (p < 0.049). Mean postoperative pain on VAS in group A was 5.34 ± 1.708 while it was 4.13 ± 1.76 in group B (P< 0.02). Conclusion: The Stapled Haemorrhoidopexy was found a better choice in term of less post-operative pain, intra-operative bleeding and operative time as compared to electrocautery Hemorrhoidectomy.

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Stapled Hemorrhoidopexy vs. Harmonic Scalpel™ Hemorrhoidectomy: A Randomized Trial

Cited by 63 publications

References 33 publications

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Stapled haemorrhoidopexy for the treatment of haemorrhoids: a systematic review

Conventional Hemorrhoidectomy with Electrocautery Versus Stapled Hemorrhoidopexy for Treatment of Haemorrhoids

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