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| |  ASCRS: Stapled Hemorrhoidectomy Less Painful, Offers Shorter Hospital Stay than Ultrasonic Dissection or Diathermy By W. A. Thomasson Special to DG News CHICAGO, IL -- June 7, 2002 -- A comparison of the three common methods of hemorrhoidectomy -- stapling, ultrasonic dissection, and diathermy -- suggests stapling is the least painful and offers the shortest hospital stays. Ki-Yeon Lee, MD, PhD, and colleagues at Kyung-Hee University in Seoul, Korea, presented the findings at the annual meeting of the American Society of Colon and Rectal Surgeons (ASCRS) by Dr. Lee and colleagues followed 150 consecutive patients treated by the same surgeon, with 50 patients receiving each of the three treatments. Results showed that hospital stay was 1.6 days for stapling, 1.7 days for ultrasonic dissection, and 2.8 days for diathermy. Operative time was likewise shortest for stapling and longest for diathermy. And on each of the first seven postoperative days, pain was greatest for diathermy and least for stapling. The mean number of piroxicam 20 mg tablets taken for pain relief was 0.3 for stapling, 1.9 for ultrasonic dissection, and 3.1 for diathermy. Patient satisfaction, evaluated using an analog scale on day 7, was 8.2 for stapling, 6.2 for ultrasonic dissection, and 5.2 for diathermy. The only complication mentioned was urinary retention, which the authors believe results from the spinal anesthesia used in all three procedures. Reports did not differ in frequency between the procedures. The authors suggested that the less painful nature of stapler hemorrhoidectomy would allow patients to return to work sooner, thus reinforcing the lower societal costs implied by a shorter hospital stay.
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