Our Summary

This research paper is about a study that compared two different methods of removing hemorrhoids, a common health problem that causes pain and discomfort. The two methods are called the harmonic scalpel (HS) and bipolar diathermy (BD). The researchers wanted to see if one method was better than the other at reducing problems during and after the operation. They looked at things like how long the operation took, how much blood was lost, how long the patient stayed in the hospital, and how long it took for the patient to have their first bowel movement after the operation. They also looked at complications after the operation, like pain, bleeding, difficulty urinating, narrowing of the anus, inability to control gas, and swelling of the wound.

To do this, they reviewed all the scientific studies that have been done on this topic up until December 2022. They only included studies that met certain criteria to make sure the results were reliable. They used statistical methods to combine the results of all these studies.

What they found was that there was no significant difference between the two methods. In other words, neither method was better or worse than the other at reducing problems during or after the operation. However, they say that more studies with larger numbers of patients are needed to confirm these results.

FAQs

  1. What are the two methods of removing hemorrhoids that the study compared?
  2. Was there a significant difference in effectiveness between the harmonic scalpel and bipolar diathermy methods in removing hemorrhoids?
  3. What factors did the researchers look at to evaluate the effectiveness of the two methods of hemorrhoid removal?

Doctor’s Tip

A doctor might tell a patient undergoing a hemorrhoidectomy to make sure to follow all post-operative care instructions carefully, including proper wound care, taking prescribed medications, and avoiding activities that could strain the surgical site. It is also important to stay well-hydrated, eat a high-fiber diet, and avoid straining during bowel movements to prevent further discomfort or complications. Lastly, it is important to attend all follow-up appointments with your healthcare provider to monitor healing and address any concerns.

Suitable For

Hemorrhoidectomy is typically recommended for patients who have severe or chronic hemorrhoids that do not respond to other treatments such as lifestyle changes, over-the-counter medications, or minimally invasive procedures. Patients with symptoms such as severe pain, bleeding, itching, swelling, or difficulty with bowel movements may be candidates for hemorrhoidectomy.

Patients with large external hemorrhoids, thrombosed hemorrhoids (blood clots in the hemorrhoid), or internal hemorrhoids that have protruded outside the anus and cannot be pushed back in may also be recommended for hemorrhoidectomy.

It is important for patients to discuss their symptoms and treatment options with a healthcare provider to determine if hemorrhoidectomy is the best course of action for their individual situation.

Timeline

Before the hemorrhoidectomy, the patient likely experiences symptoms such as pain, itching, bleeding, and discomfort in the anal area. They may have tried conservative treatments such as dietary changes, topical creams, and sitz baths with limited success.

After the decision is made to proceed with a hemorrhoidectomy, the patient will typically undergo pre-operative evaluations and tests to ensure they are healthy enough for surgery. They may also be instructed to stop certain medications or adjust their diet in preparation for the procedure.

During the hemorrhoidectomy, the surgeon will remove the hemorrhoids using either the harmonic scalpel or bipolar diathermy method. The operation typically takes about 30-45 minutes, and the patient is usually placed under general anesthesia or local anesthesia with sedation.

After the hemorrhoidectomy, the patient may experience pain, swelling, and discomfort in the anal area. They will be given pain medications and instructions on how to care for the surgical site. It may take a few weeks for the patient to fully recover and resume normal activities.

In the weeks following the surgery, the patient will have follow-up appointments with their surgeon to monitor their healing progress and address any concerns. They may also be advised to make lifestyle changes to prevent future hemorrhoids, such as eating a high-fiber diet, staying hydrated, and avoiding straining during bowel movements.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a hemorrhoidectomy procedure?
  2. How long is the recovery period after a hemorrhoidectomy and what can I expect during this time?
  3. Will I need to make any lifestyle or dietary changes after the procedure to prevent future hemorrhoids?
  4. Are there any alternative treatments or procedures that could be considered instead of a hemorrhoidectomy?
  5. What is the success rate of hemorrhoidectomy procedures using the harmonic scalpel versus bipolar diathermy?
  6. How experienced are you in performing hemorrhoidectomy procedures and what is your success rate with this surgery?
  7. What type of anesthesia will be used during the procedure and what are the potential side effects or risks associated with it?
  8. Will I need to stay overnight in the hospital after the procedure or is this an outpatient procedure?
  9. How soon after the procedure can I return to normal activities, such as work or exercise?
  10. Are there any long-term risks or complications associated with a hemorrhoidectomy that I should be aware of?

Reference

Authors: Albazee E, Alenezi A, Alenezi M, Alabdulhadi R, Alhubail RJ, Ahmad Al Sadder K, AlDabbous F, Almutairi AN, Almutairi SN, Almutairi AN, Alenezi MS. Journal: Cureus. 2023 Feb 7;15(2):e34734. doi: 10.7759/cureus.34734. eCollection 2023 Feb. PMID: 36755770