PROSPECTIVE, RANDOMIZED TRIAL COMPARING PAIN AND COMPLICATIONS BETWEEN DIATHERMY AND SCISSORS FOR CLOSED HEMORRHOIDECTOMY

PURPOSE: The aim of this study was to assess pain and complication rat es after closed hemorrhoidectomy with the use of either scissors or di athermy excision. METHODS: Ninety-one consecutive patients were prospe ctively randomly assigned by use of sealed envelopes to Group A (diath ermy dissection; n = 44) or Group B (scissors dissection; n = 47). The resulting hemorrhoidal pedicle after hemorrhoidal dissection was tran sfixed and buried under the mucosa, which was closed with 3-0 chromic catgut. RESULTS: The median time taken for surgery was ten minutes in both groups. The range for Group A was 5 to 25 minutes, and the range for Group B was 5 to 20 minutes. There were no statistically significa nt differences in the pain scores between the two groups for any of th e seven postoperative days studied. The median number of pethidine inj ections in Group A was 1 and in Group B was 0 (P < 0.009). The number of oral analgesic tablets used was 8 (range, 4-10) and 14 (range, 0-10 ) for Groups A and B, respectively (P < 0.001). The number of tubes of topical Lignocaine jelly used was 14 (range, 0-22) and 14 (range, 7-8 8) in Groups A and B, respectively. Two patients in each group develop ed secondary hemorrhage, but no patient had anal stricturing. CONCLUSI ON: No excessive complications are seen with closed hemorrhoidectomy, and diathermy seems to require less postoperative analgesic medicine t han scissors for closed hemorrhoidectomy except in the first 24 hours.