Hemorrhoidectomy in Patients With Grade III and IV Disease:Harmonic Scalpel Compared With Conventional Technique
Condition: Hemorrhoidectomy; Third Degree Hemorrhoids; Fourth Degree Hemorrhoids; Operative Time; Postoperative,Pain; Length of Stay
MeSH terms: Hemorrhoids
Study type: Interventional

Summary: 
      Hemorrhoidectomy is the treatment of choice for grade 3 and 4th degree hemorrhoids. Various
      surgical technique has been used to improve the outcome of the procedures performed in
      respect to operative time ,post operative pain and hospital stay. This study compares the
      conventional closed technique with harmonic scalpel technique which is a device regulated
      with ultrasonic waves to perform the procedure with minimal postoperative complication as
      well as decreasing the prolong stay in hospital.
    

Detailed description: 
      INTRODUCTION:

      Ferguson closed hemorrhoidectomy is conventional procedure in 3rd and 4th degree hemorrhoids
      but recent advances in harmonic scalpel have shown to produce favorable results. Comparison
      of these two is studied in terms of pain outcome as patient perceives, operative time and
      duration of hospital stay.

      OBJECTIVES:

      To compare the outcome of conventional hemorrhoidectomy versus harmonic scalpel in III and IV
      degree hemorrhoids.

      STUDY DESIGN:

      Randomized controlled trial

      STUDY SETTING:

      The study was conducted in surgical unit 1, Services hospital, Lahore.

      DURATION OF STUDY:

      Study was completed in six months after the approval of synopsis i.e. from 27th August 2015
      to 26th February 2016.

      DATA COLLECTION PROCEDURE:

      After approval from hospital ethical committee, 100 patients fulfilling the inclusion
      criteria had been recruited from outdoor and emergency department. A detailed history had
      been taken including demographic data (age, address) and all patients had been clinically
      examined .Patients was divided in two groups randomly using random number tables. Group A:
      Conventional hemorrhoidectomy. Group B: harmonic scalpel hemorrhoidectomy. Patients had been
      requested to sign an informed consent. They had been assured regarding confidentiality and
      expertise used for the procedure. All procedures had been performed by a single surgical
      operating team to control bias. Per operatively operative time was noted. Post operatively
      pain had been assessed in 24 hours , mean hospital stay was measured in days from
      postoperative day till day of discharge (as per operational definition). All data had been
      collected and recorded on the attached Performa.
    

Intervention name(s): Hemorrhoidectomy
Intervention type(s): Procedure
Intervention description(s): Excision of third and fourth degree hemorrhoids
Other intervention name(s): Ferguson Closed Hemorrhoidectomy
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Coagulating Shears ® model
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: VAS pain score; Harmonic Scalpel Hemorrhoidectomy; Conventional Hemorrhoidectomy