Comparison Outcome of Vessel-Sealing Devices Hemorrhoidectomy Versus Conventional Ferguson Hemorrhoidectomy in Samut Prakan Hospital

Abstract

Background: Hemorrhoidal disease is one of the most common anorectal diseases and surgical hemorrhoidectomy, it remains one of the most common operations in general surgery for patients with internal hemorrhoid grade 3 and 4. Milligan-Morgan and Ferguson described the conventional hemorrhoidectomy since about 70 years ago. In the last decade, many studies show that Vessel-Sealing Devices hemorrhoidectomy seems to be very effective treatment and results in better surgical outcomes when compared with the conventional hemorrhoidectomy. Objective: This study aims to compare the outcome of haemorrhoidectomy done by Vessel-Sealing Devices technique with conventional Ferguson technique. Methods: This retrospective study was done at Samut Prakan Hospital over a period from 1 July 2016 to 31 December 2018 on the basis of: It included 90 adult patients with 3rd and 4th degree hemorrhoids divided into 2 groups: Group one (53 patients) underwent Conventional Ferguson hemorrhoidectomy. Group two (37 patients) underwent Vessel-Sealing Devices hemorrhoidectomy. The outcomes of two groups were compared using the Chi-square test and Fisher’s exact test. A p-value less than 0.05 was considered statistically significant. Results: The results of the operations by using between Vessel-Sealing Devices hemorrhoidectomy and Conventional Ferguson hemorrhoidectomy, there were statistically significant difference in terms of operative time (8.0 ± 5.0 minutes and 20.6 ± 12.5 minutes; p<0.001), intraoperative blood los s(2.7 ± 1.3 milliliters and 11.6 ± 4.0 milliliters; p<0.001) , pain score at post operative 1st day (3.6 ± 1.2 and 6.3 ± 1.3; p<0.001) and 2nd day (2.0 ± 1.1 and 4.1 ± 1.1; p<0.001), length of hospital stay (1.2 ± 0.6 days and 2.3 ± 2.2 days; p = 0.003), dose of NSAIDs used (3.0 ± 0.8 dose and 5.0 ± 2.1 dose; p <0.001), and wound healing time (3.3 ± 0.6 weeks and 5.6 ± 1.0 weeks 0; p<0.001). But post operative complication and hospital cost were not statistically significant different between two groups. Conclusion: Vessel-Sealing Devices hemorrhoidectomy is better than Conventional Ferguson hemorrhoidectomy in terms of less operative time, less post-operative pain, less intraoperative blood loss, length of hospital stay, less post-operative analgesics and earlier wound healing.