대한대장항문학회

Purpose: Hemorrhoidectomy is considered to be a painful operation, therefore some patients with symptomatic hemorrhoids conceal their symptoms to defer a much-needed surgical procedure. Patients who have undergone hemorrhoidectomy have<br>experienced<br>constipation or urinary retention due to postoperative pain. Several interventions have been used to relieve postoperative pain after hemorrhoidectomy. Nevertheless, the results are unsatisfactory. Hemorrhoidectomy with ultrasonic dissector have<br>less<br>thermal injury and can avoid ligation and suture. This study compared conventional semi-open Milligan hemorrhoidectomy with open ultrasonic dissector hemorrhoidectomy.<br>Methods: One hundred patients with prolapsed symptomatic hemorrhoids were randomly assigned to semi-open Milligan (n=50) or open ultrasonic dissector (n=50) hemorrhoidectomy. Operation time, postoperative complication, hospital stay, degree and<br>duration<br>of postoperative pain, pain on bowel movement, and urinary retention were recorded and analyzed.<br>Results: There was no significant difference in excised pile number. Operation time of open ultrasonic dissector hemorrhoidectomy was shorter than that of semi-open Milligan hemorrhoidectomy (P＜0.05). The open ultrasonic dissector<br>hemorrhoidectomy<br>group resulted in less postoperative pain (P＜0.05) and shorter duration of pain (P＜0.05) and postoperative hospital stay (P＜0.05) than semi- open Milligan hemorrhoidectomy. Urinary retention did not occur in both groups.<br>Conclusions: Despite the higher cost, open ultrasonic dissector hemorrhoidectomy results in less postoperative pain, shorter operation time and hospital stay than the conventional hemorrhoidectomy.<br>