Prospective, randomized trial comparing pain and complications between diathermy and scissors for closed hemorrhoidectomy.

Abstract

PURPOSE:

The aim of this study was to assess pain and complication rates after closed hemorrhoidectomy with the use of either scissors or diathermy excision.

METHODS:

Ninety-one consecutive patients were prospectively randomly assigned by use of sealed envelopes to Group A (diathermy dissection; n = 44) or Group B (scissors dissection; n = 47). The resulting hemorrhoidal pedicle after hemorrhoidal dissection was transfixed and buried under the mucosa, which was closed with 3-0 chromic catgut.

RESULTS:

The median time taken for surgery was ten minutes in both groups. The range for Group A was 5 to 25 minutes, and the range for Group B was 5 to 20 minutes. There were no statistically significant differences in the pain scores between the two groups for any of the seven postoperative days studied. The median number of pethidine injections in Group A was 1 and in Group B was 0 (P < 0.009). The number of oral analgesic tablets used was 8 (range, 4-10) and 14 (range, 0-10) for Groups A and B, respectively (P < 0.001). The number of tubes of topical lignocaine jelly used was 14 (range, 0-22) and 14 (range, 7-88) in Groups A and B, respectively. Two patients in each group developed secondary hemorrhage, but no patient had anal stricturing.

CONCLUSION:

No excessive complications are seen with closed hemorrhoidectomy, and diathermy seems to require less postoperative analgesic medicine than scissors for closed hemorrhoidectomy except in the first 24 hours.

• Authors: S Ibrahim, C Tsang, Y L Lee, K W Eu, F Seow-Choen
• Journal: Diseases of the colon and rectum (Dis Colon Rectum) Vol. 41 Issue 11 Pg. 1418-20 (Nov 1998) ISSN: 0012-3706 [Print] United States
• PMID: 9823809 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Topics

• Adult
• Aged
• Aged, 80 and over
• Colorectal Surgery (instrumentation)
• Diathermy
• Hemorrhoids (surgery)
• Humans
• Middle Aged
• Pain, Postoperative
• Postoperative Complications
• Prospective Studies