Randomized controlled trial of bipolar diathermy vs ultrasonic scalpel for closed hemorrhoidectomy

被引:12
作者
Tsunoda, Akira [1 ]
Sada, Haruki [1 ]
Sugimoto, Takuya [1 ]
Kano, Nobuyasu [1 ]
Kawana, Mariko [2 ]
Sasaki, Tadanori [2 ]
Hashimoto, Hideki [3 ]
机构
[1] Kameda Med Ctr, Dept Surg, 929 Higashi Cho, Kamogawa City, Chiba 2968602, Japan
[2] Kameda Med Ctr, Dept Pharm Serv, Chiba 2968602, Japan
[3] Univ Tokyo, Sch Publ Hlth, Dept Hlth Econ & Epidemiol Res, Tokyo 1088639, Japan
关键词
Hemorrhoidectomy; Ligasure (TM); Harmonic Scalpel (TM); Randomized controlled trial; Pain;
D O I
10.4240/wjgs.v3.i10.147
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
AIM: To compare hemorrhoidectomy with a bipolar electrothermal device or hemorrhoidectomy using an ultrasonically activated scalpel. METHODS: Sixty patients with grade. or. hemorrhoids were prospectively randomized to undergo closed hemorrhoidectomy assisted by bipolar diathermy (group 1) or hemorrhoidectomy with the ultrasonic scalpel (group 2). Operative data were recorded, and patients were followed at 1, 3, and 6 wk to evaluate complications. Independent assessors were assigned to obtain postoperative pain scores, oral analgesic requirement and satisfaction scores. RESULTS: Reduced intraoperative blood loss median 0.9 mL (95% CI: 0.8-3.7) vs 4.6 mL (95% CI: 3.8-7.0), P = 0.001 and a short operating time median 16 (95% CI: 14.6-18.2) min vs 31 (95% CI: 28.1-35.3) min, P < 0.0001 was observed in group 1 compared with group 2. There was a trend towards lower postoperative pain scores on day 1 group 1 median 2 (95% CI: 1.8-3.5) vs group 2 median 3 (95% CI: 2.6-4.2), P = 0.135. Reduced oral analgesic requirement during postoperative 24 h after operation median 1 (95% CI: 0.4-0.9) tablet vs 1 (95% CI: 0.9-1.3) tablet, P = 0.006 was observed in group 1 compared with group 2. There was no difference between the two groups in the degree of patient satisfaction or number of postoperative complications. CONCLUSION: Bipolar diathermy hemorrhoidectomy is quick and bloodless and, although as painful as closed hemorrhoidectomy with the ultrasonic scalpel, is associated with a reduced analgesic requirement immediately after operation. (C) 2011 Baishideng. All rights reserved.
引用
收藏
页码:147 / 152
页数:6
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