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치핵절제술에 대한 Harmonic Scalpel 의 유용성

The Usefulness of a Harmonic Scalpel for Hemorrhoidectomy

대한대장항문학회지 2002년 18권 1호 p.10 ~ 14
최규형 ( Choi Kyu-Hyung ) - 홍문외과

김유용 ( Kim Yu-Young ) - 홍문외과
장의명 ( Jang Eu-Myung ) - 홍문외과

Abstract


Purpose: The aim of this study was to compare conventional scissors and Harmonic Scalpel® hemorrhoidectomy.

Methods: Two hundred and five patients were prospectively assigned to two groups in the consecutive order.
The group was divided into Group A (Harmonic Scalpel excision; n=101) and Group B (conventional scissor excision; n=104). All other aspects of surgery and anesthesia were standardized. Intramuscular opiate was available on demand during the postoperative period, and analgesic requirements were also recorded. All patients noted their pain on a daily basis using a visual analogue scale (0=no pain; 10=worst pain). The length of hospitalization, operative time and postoperative complications were also analyzed.

Results: The operative time was 16.6±0.9 minutes 25.3±0.8 minutes in Group A and B, respectively (p<0.01). Length of hospital stay was 4.1±0.1 and 4.5±0.1 days (p<0.05). Pain scores in the group A were significantly lower
than in the group B (p<0.01). Analgesic requirements were also significantly less in group A (p<0.05). Postoperative complications, such as urinary retention, fecal impaction and skin tags were rarer in group A. One patient in group A and two patients in group B developed secondary hemorrhage, but no patient had anal stricture.

Conclusions: The Harmonic Scalpel excision significantly shortens the operative time for hemorrhoidectomy with less blood loss and postoperative pain without remarkable early or late postoperative complications.

키워드

치핵절제술;수술 후 통증;출혈;Hemorrhoidectomy
Harmonic Scalpel;Postoperative pain;Bleeding
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