A Comparative Study of Hemorrhoid Surgery Vessel-Sealing Devices Hemorrhoidectomy with Traditional Surgery (Conventional Ferguson Hemorrhoidectomy) in Amnat Charoen Hospital Amnat Charoen Province

Abstract

Background: Hemorrhoids are a common disease in medical practice and hemorrhoid surgery is often performed by surgeons in grade 3 and 4 hemorrhoids from the past until the present. In the past, conventional hemorrhoidectomy (Milligan-Morgan or Ferguson) was used. Current use of tools; the trend of electrothermal bipolar vessel sealing systems (Ligasure TM) in assisting surgery is increasing. Many studies have reported that it is a reliable and safe tool. Many studies have shown the use of surgical tools developed as Vessel-Sealing Devices Hemorrhoidectomy which gives better results in many ways.

Objective: To study and compare pain after hemorrhoid surgery. Clinical results (Surgery time Length of hospital stay including patient satisfaction and complications associated with conventional surgery. Conventional Ferguson hemorrhoidectomy with surgery using Vessel-Sealing Devices in Amnat Charoen Hospital.

Study style: Experimental study.

Methods: Retrospective data were collected from the medical records of patients diagnosed with grade 3 and 4 hemorrhoids from 1 October 2021 to 30 September 2022. The total number of patients was 95, divided into 2 groups. Namely, the group that received Conventional Ferguson hemorrhoidectomy, 50 cases, the group that received surgery Vessel-Sealing Devices hemorrhoidectomy 45 cases. They were analyzed and compared with the time required for surgery. Amount of bleeding during surgery postoperative pain score length of hospital stay, amount of NSAIDs given after surgery wound healing time cost of hospital stay, and postoperative complications. The results obtained from both groups will be compared with statistics. Chi-square test and Fisher'sexact test, which analyzed inferential statistics at the statistical significance level p-value < 0.05.

Results: It was found that the duration of surgery amount of bleeding during surgery postoperative pain score length of hospital stay Amount of NSAIDs given after surgery, and wound healing time in patients who have undergone surgery Vessel-Sealing Devices hemorrhoidectomy were less than those who received Conventional Ferguson hemorrhoidectomy. Statistically significant; by surgery time (8.01 ± 4.82 minutes and 20.82 ± 12.51 minutes; p < 0.001), intraoperative bleeding volume (2.81 ± 1.32 ml and 15.71 ± 14.05 ml; p < 0.001), postoperative pain scores on the first day (3.82 ± 1.22 and 7.31 ± 1.31; p < 0.001) and the second day (2.08 ± 1.10 and 4.15 ± 1.11; p < 0.001), length of hospital stay (1.82 ± 0.71 days 2.51 ± 2.21; p< 0.001), amount of NSAIDs received postoperatively (3.03 ± 0.81 times and 5.44 ± 2.22 times; p < 0.001), and wound healing rate (3.51 ± 0.74 weeks and 5.84 ± 1.23 weeks 0; p < 0.001). Therefore, the use of Vessel-Sealing Devices hemorrhoidectomy is used to operate on level 3 and 4 hemorrhoids, so it has such benefits and when considering the cost and condition complications were found to be not significantly different between the two methods.

Conclusion: Surgery time amount of bleeding during surgery postoperative pain scores on the first and second-day length of hospital stay amount of NSAIDs given after surgery wound healing time in patients who have undergone Vessel-Sealing Devices hemorrhoidectomy less than those who received Conventional Ferguson hemorrhoidectomy. Statistically significant.