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Ligasure, Harmonic Scalpel versus conventional diathermy in excisional haemorrhoidectomy: a randomized controlled trial
Author(s) -
Talha Ahmed,
Bessa Samer,
Abdel Wahab Moataza
Publication year - 2017
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12838
Subject(s) - medicine , diathermy , harmonic scalpel , surgery , analgesic , electrocoagulation , randomized controlled trial , significant difference , anesthesia , blood loss
Background This study was designed to compare the surgical outcomes of haemorrhoidectomy performed by the Ligasure, Harmonic Scalpel with that performed by the conventional diathermy. Methods A total of 180 patients were randomized to Ligasure, Harmonic Scalpel and diathermy haemorrhoidectomy, 60 patients for each group. The operative time, post‐operative pain scores, parenteral analgesic requirements in the first 24 h, post‐operative complications and wound healing rates were documented. Results The median operative time was 8 min (range, 7–18) for the Ligasure and Harmonic Scalpel groups and 18 min (range, 15–21) for the diathermy group ( P < 0.001). Throughout the first post‐operative week, the daily median pain score was lower in the Ligasure and Harmonic Scalpel groups than in the diathermy group ( P < 0.001). The median number of analgesic ampoules during the first 24 h post‐operatively was lower in the Ligasure and Harmonic Scalpel groups ( P < 0.001). There was no statistically significant difference in the incidence of post‐operative complications. At 6 weeks post‐operation, more patients in the Ligasure and Harmonic Scalpel groups had complete healing of wounds ( P = 0 < 0.001). Conclusion Ligasure and Harmonic Scalpel provide a superior alternative to conventional diathermy in haemorrhoidectomy with no difference between them in reducing the operative time, post‐operative pain, analgesic requirements during the first 24 h and time to complete healing of wounds.