대한대장항문학회

<b>Purpose:</b> The aim of this study was to compare conventional scissors and Harmonic Scalpel<sup>®</sup> hemorrhoidectomy. <b>Methods:</b> Two hundred and five patients were prospectively assigned to two groups in the consecutive order.<br>The<br>group<br>was divided into Group A (Harmonic Scalpel<sup>®</sup> excision; n=101) and Group B (conventional scissor excision; n=104). All other aspects of surgery and anesthesia were standardized. Intramuscular opiate was available on demand during the<br>postoperative period, and analgesic requirements were also recorded. All patients noted their pain on a daily basis using a visual analogue scale (0=no pain; 10=worst pain). The length of hospitalization, operative time and postoperative<br>complications<br>were also analyzed. <b>Results:</b> The operative time was 16.6?.9 minutes 25.3?.8 minutes in Group A and B, respectively (p<0.01). Length of hospital stay was 4.1?.1 and 4.5?.1 days (p<0.05). Pain scores in the group A were significantly<br>lower<br>than in the group B (p<0.01). Analgesic requirements were also significantly less in group A (p<0.05). Postoperative complications, such as urinary retention, fecal impaction and skin tags were rarer in group A. One patient in group A and two<br>patients<br>in group B developed secondary hemorrhage, but no patient had anal stricture. <b>Conclusions:</b> The Harmonic Scalpel<sup>®</sup> excision significantly shortens the operative time for hemorrhoidectomy with less blood loss and postoperative<br>pain<br>without remarkable early or late postoperative complications.<br>