Stapled hemorrhoidopexy vs. Harmonic Scalpel hemorrhoidectomy: a randomized trial

Area of Science:

• Colorectal Surgery
• Surgical Innovation
• Hemorrhoidal Disease Treatment

Background:

• Hemorrhoidal disease affects a significant portion of the population.
• Traditional excisional hemorrhoidectomy can be associated with considerable postoperative pain.
• Minimally invasive techniques aim to improve patient outcomes and reduce recovery time.

Purpose of the Study:

• To compare the efficacy and safety of stapled hemorrhoidopexy versus Harmonic Scalpel excisional hemorrhoidectomy.
• To evaluate postoperative pain, patient satisfaction, and return to work.
• To assess the impact of smooth muscle inclusion in stapled specimens on continence.

Main Methods:

• A randomized trial involving 88 patients with Grade III hemorrhoids.
• Patients were randomized to either stapled hemorrhoidopexy or Harmonic Scalpel hemorrhoidectomy.
• Data collected included operative time, blood loss, complications, pain scores, satisfaction, and continence function.

Main Results:

• Stapled hemorrhoidopexy demonstrated significantly better postoperative pain scores (P = 0.002) and patient satisfaction (P = 0.001).
• Patients undergoing stapled hemorrhoidopexy returned to work significantly earlier (9 days sooner, P = 0.002) with a shorter length of stay (P = 0.02).
• No significant difference in complication rates or continence outcomes was observed between the two groups.

Conclusions:

• Stapled hemorrhoidopexy is a safe and effective treatment for Grade III hemorrhoidal disease.
• The procedure provides significant short-term benefits, including reduced pain and quicker recovery.
• Further long-term follow-up is warranted to confirm the durability of these results.