Geleneksel diyatermi ile kıyaslandığında harmonik bistürinin hemoroidektomide faydası var mıdır?

Öz

Amaç: Semptomatik hemoroidal hastalık, en yaygın cerrahi hastalıklar arasındadır ve tedavide cerrahi müdahale gerekebilir. Cerrahi tedavide etkili yaklaşımlar harmonik bistüri ile hemoroidektomi ve konvansiyonel diyatermi ile eksizyondur. Çalışmanın amacı, harmonik bistüri ve konvansiyonel diyatermi eksizyon teknikleriyle yapılan hemoroidektomi sonuçlarını karşılaştırmaktı.

Yöntemler: Semptomatik Evre III-IV hemoroid nedeniyle ardışık operasyon yapılan 113 hasta (26 kadın, % 23; 87 erkek, % 77) dosyaları retrospektif olarak incelendi ve operasyon ve hastanede kalış süresi, erken ve gecikmiş kanama, idrar yapmada zorluk, postoperatif apse ve anal stenoz araştırıldı. Dışlama kriterleri; ek cerrahi uygulanması, rekürren vakalar ve inflamatuvar bağırsak hastalığı idi. 

Bulgular: Altmış hastada (%53) konvansiyonel diyatermi ile hemoroidektomi ve 53 hastada (%47) harmonik bistüri ile hemoroidektomi uygulandı. Operasyon ve yatış süreleri arasında harmonik bistüri grubu lehine anlamlı farklılık tespit edildi (her ikisi için p<0,05). Diğer parametrelerde anlamlı bir farklılık yoktu (hepsi için p>0,05).

Sonuç: Harmonik bistüri ile hemoroidektomi, ameliyat süresinin kısa olması ve hastaneden daha erken taburcu olmasına karşın ek bir komplikasyona rastlanmadığı için konvansiyonel diyatermi hemoroidektomisine göre avantajlıdır.

Anahtar Kelimeler

• Harmonik,Hemoroidektomi,Bistüri,Cerrahi,Teknik

Is there any benefit of harmonic scalpel for hemorrhoidectomy versus conventional diathermy?

Abstract

Aim: Symptomatic hemorrhoidal disease is among the most common surgical diseases and it may necessitate surgical intervention. The most common and effective approaches used for surgical treatment are harmonic scalpel hemorrhoidectomy and conventional diathermy excision. The aim of the study was to compare the outcomes of hemorrhoidectomy using harmonic scalpel and the conventional diathermy excision techniques. 

Methods: The files of 113 consecutively operated patients (26 females 23%, 87 males 77%), who were operated on for symptomatic Grade III–IV hemorrhoids, were retrospectively reviewed for length of operation and hospitalization, early and delayed bleeding, urinary retention, postoperative abscess and anal stenosis. Exclusion criteria were additional operations, recurrent cases and inflammatory bowel disease. 

Results: Conventional diathermy hemorrhoidectomy in 60 (53%) and harmonic scalpel hemorrhoidectomy were used in 53 patients (47%). There were significant differences between the operation and hospitalization times in favor of harmonic scalpel group (p<0.05 for both). The other parameters did not show any significant differences (p>0.05 for all). 

Conclusion: Harmonic scalpel hemorrhoidectomy is advantageous and superior to conventional diathermy hemorrhoidectomy in regard to shorter operation time and earlier discharge from the hospital with no additonal complications.

Keywords

• harmonic,hemorrhoidectomy,scalpel,surgery,technique

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