title: Short- and long-term results of harmonic scalpel hemorrhoidectomy versus stapler hemorrhoidopexy in treatment of hemorrhoidal disease.
abstract: OBJECTIVE
  In this prospective randomized study, our aim is to compare the short- and long-term results of harmonic scalpel hemorrhoidectomy (HSH) and stapler hemorrhoidopexy (SH) methods in the surgical treatment of Grade III and Grade IV hemorrhoidal disease.
  
  
  METHODS
  Ninety-nine consecutive patients diagnosed with Grade III or Grade IV internal hemorrhoidal disease were included in the study. Patients were randomized to HSH (n = 48) or SH (n = 51) treatments. Data on patient demographic and clinical characteristics, operative details, postoperative pain score on a visual analog scale, additional analgesic requirement, postoperative short- and long-term complications, and recurrence of hemorrhoidal disease were also recorded. Patients were regularly followed for a total period of 24 (6-36) months.
  
  
  RESULTS
  The patient demographic and clinical characteristics were similar in the two groups. The operative time was significantly shorter in the HSH group compared with the SH group. Overall pain scores were not significantly different between the groups, although severe pain was significantly more common in the HSH group. Recurrence was significantly lower in the HSH group compared with the SH group.
  
  
  CONCLUSIONS
  HSH and SH are both safe and effective methods for surgical treatment of Grade III and Grade IV hemorrhoidal disease. In our study, the HSH method was determined to be safer, easier, and faster to perform, and associated with fewer long-term recurrences than the SH method.
authors.affiliation: General Surgery Department, Okmeydanı Training Research Hospital, Istanbul, Turkey.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Bilgin
authors.affiliation: General Surgery Department, Okmeydanı Training Research Hospital, Istanbul, Turkey. Electronic address: semihhot@hotmail.com.
authors.forename: Semih
authors.initials: S
authors.lastname: Hot
authors.affiliation: General Surgery Department, Okmeydanı Training Research Hospital, Istanbul, Turkey.
authors.forename: İlhami Soykan
authors.initials: İS
authors.lastname: Barlas
authors.affiliation: General Surgery Department, Okmeydanı Training Research Hospital, Istanbul, Turkey.
authors.forename: Arzu
authors.initials: A
authors.lastname: Akan
authors.affiliation: General Surgery Department, Okmeydanı Training Research Hospital, Istanbul, Turkey.
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Eryavuz
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D061865:Hemorrhoidectomy / Q000295:instrumentation / Q000379:methods*; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011446:Prospective Studies; D012008:Recurrence; D017792:Surgical Stapling; D016896:Treatment Outcome; D059708:Ultrasonic Surgical Procedures / Q000295:instrumentation / Q000379:methods*
keywords: harmonic scalpel; stapled hemorrhoidopexy