Comparison among LigaSure, Harmonic Scalpel, and Conventional Hemorrhoidectomy for Symptomatic Hemorrhoids

使用組織凝集器（LigaSure）、諧波刀（Harmonic scalpel）切除痔瘡與傳統痔瘡手術之比較

林怡成(I-Chen Lin) ； 黃允中(Yun-Chung Huang) ； 朱峻廷(Chun-Ting Chu) ； 方川尹(Chuan-Yin Fang)

《中華民國大腸直腸外科醫學會雜誌》 30卷3期 (2019/09) Pp. 127-134

https://doi.org/10.6312/SCRSTW.201909_30(3).10815

摘要

Purpose. This study aimed to compare the short-term outcomes of LigaSure and Harmonic Scalpel hemorrhoidectomy with those of conventional hemorrhoidectomy. Methods. We assessed patients with Grade III or IV hemorrhoids who underwent LigaSure, Harmonic Scalpel, or conventional hemorrhoidectomy from July 2018 to January 2019. A total of 50 patients were included in this study. Results. The patients were divided into three groups: conventional (n = 18), LigaSure (n = 16), and Harmonic Scalpel hemorrhoidectomy (n = 16). The median operation time was 17.5 min for the LigaSure hemorrhoidectomy group, 18.75 min for the Harmonic Scalpel hemorrhoidectomy group, and 28.89 min for the conventional hemorrhoidectomy group (p ＜ 0.001). Further, intraoperative blood loss and pain scores were significantly lower in the LigaSure and Harmonic Scalpel hemorrhoidectomy groups than in the conventional hemorrhoidectomy group (p ＜ 0.001). The median number of analgesic injections used during admission and hospital days was lower in the LigaSure and Harmonic Scalpel hemorrhoidectomy groups than in the conventional hemorrhoidectomy group (p ＜ 0.05). However, no significant difference was observed in terms of the incidence of early postoperative complications. Conclusions. LigaSure and Harmonic Scalpel hemorrhoidectomy provide a superior alternative to conventional hemorrhoidectomy owing to shorter operation time and length of hospital stay as well as lower postoperative pain, volume of blood loss, and analgesic requirements.

關鍵字

LigaSure ； Harmonic Scalpel ； Hemorrhoidectomy

並列摘要

目的：比較組織凝集器（LigaSure）、諧波刀（Harmonic scalpel）切除痔瘡與傳統痔瘡手術的結果。方法：收集並統計自2018年7月至2019年1月間，第三與第四級痔瘡使用組織凝集器、諧波刀手術及傳統痔瘡切除手術進行比較。共50位病人分為三組，比較彼此之間各方面的差別。結果：使用組織凝集器及諧波刀進行痔瘡切除手術比傳統痔瘡手術能有效減少開刀時間及術中流血量；而且在住院天數、術後疼痛和術後施打止痛藥劑數用組織凝集器及諧波刀進行痔瘡切除手術也是明顯優於傳統痔瘡手術。結論：使用組織凝集器（LigaSure）或諧波刀（Harmonic Scalpel）進行痔瘡切除手術，能夠比傳統手術達到更好的結果。

並列關鍵字

織凝集器（LigaSure） ； 諧波刀（Harmonic Scalpel） ； 痔瘡切除術

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