*Abdulaziz Abood Majeed, (M.B.Ch.B, C. A. B. S, F. I. B. M. S, D. G. S) and Ziyad Tariq Abbas (M.B.Ch.B, H.D.G.S)


Background: Recently, efforts were made to find less painful and less complicated surgical methods for treatment of hemorrhoids. A variety of instruments used, including circular staplers, harmonic scalpels, lasers, and bipolar electrothermal devices. Aim of study: To compare the outcome of patients with grade III or IV disease who underwent hemorrhoidectomy using harmonic scalpel or conventional closed technique. Patients and Methods: Comparative prospective study included 60 patients underwent hemorrhoidectomy was conducted in the surgical unit, Department of Surgery, Al-Numan Teaching Hospital in Baghdad during a period of 18 months from 1st of Feb, 2018 – 31th Jul, 2019. They divided randomly into two equal groups: harmonic group treated by harmonic scalpel method and conventional group treated by conventional method. They were compared regarding Intra operative bleeding, operative time, postoperative pain, early postoperative complications, length of hospital stay, and duration to return to normal activity. Patients with thrombosed or strangulated hemorrhoids, with a known case of tendencies for bleeding, with concomitant perianal disease, with a history of recurrent perianal surgeries, or those unfit for surgery or anesthesia were excluded from this study. Results: No statistical significant differences between study groups regarding age, gender, BMI level, and grade of disease. Bleeding was significantly less than bleeding occurred in patients treated by conventional method. Postoperative pain and time to return to work and daily activities were significantly less in patients managed by harmonic scalpel method. Conclusion: Both of harmonic scalpel or conventional method are an effective and safe procedures in hemorrhoidectomy. Harmonic scalpel method is preferred as it reduces the postoperative pain and bleeding and duration of returning to work and daily activities compared to conventional method.

Keywords: hemorrhoidectomy, harmonic scalpel, conventional, Iraq.

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