January-March 2018

A Prospective Randomised Study of Comparing Diathermy and Ultrasonic Scalpel Haemorrhoidectomy

Jatin G. Bhatt1, Arvind Ranwa2*, Jignesh P. Dave3, Iliyas Juneja4, Hitesh Meghani5, Vikrant Patel6

1M.S., Professor & Head, 2,6M.B.B.S, Resident Doctor, 3,4M.S., Associate professor, 5M.S., Assistant Professor P.D.U. Medical College and Hospital, Rajkot, Gujarat, India


ABSTRACT BACKGROUND: Haemorrhoidectomy is the most effective approach for haemorrhoidal disease especially for grade III and grade IV disease. However, postoperative pain is a major concern, and the surgery itself is with complications including notably bleeding, wound sepsis, pain, and anal stenosis. MATERIALS AND METHODS: The study was carried out from 1st July 2014 to 30th Sep 2016 and 50 cases of 3rd and 4th degree haemorrhoids were selected with complaints of bleeding per rectum, pain during defecation and discharge. The patients were explained about their disease and modalities of treatment as ultrasonic scalpel or diathermy haemorrhoidectomy with advantages and disadvantages of each. Analysis was made on basis of percentages and mean. Randomly selected 25 patients were operated by ultrasonic scalpel & another 25 patients by diathermy haemorrhoidectomy under spinal anaesthesia. RESULTS: Ultrasonic scalpel haemorrhoidectomy take about 20 to 35 minutes while diathermy haemorrhoidectomy take about 30 to 45 minutes. The VAS pain scores on postoperative Day 1, 3, and 7 of the Ultrasonic Scalpel group were 5.8, 4.2 and 3.8 respectively and of the Diathermy haemorrhoidectomy group were 7.0, 6.2 and 4.2 respectively. Post-op bleeding in form of soakage of per-anal dressing was seen in only 4% cases in ultrasonic group while 12% cases in diathermy group. CONCLUSION: Ultrasonic scalpel haemorrhoidectomy is preferred for surgical treatment of grade III and grade IV haemorrhoids. It is safe and effective, and causes less intra-operative blood loss, less post-operative pain and less complications compared to diathermy haemorrhoidectomy.

Keywords: Diathermy, ultrasonic scalpel, haemorrhoidectomy

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