Comparative efficiency of apparatus-controlled coagulation and traditional method of surgical treatment in patients with grade III and IV hemorrhoids
Summary. The aim is to compare the clinical results of electrocoagulation hemostatic device LigaSureTM (ECHD) hemorrhoidectomy and Milligan — Morgan hemorrhoidectomy. Object and methods of research. This study included 182 patients both sexes aged 16–80 with grade III and IV hemorrhoids who underwent hemorrhoidectomy with ECHD (n=78) or conventional method (n=104). Patients were retrospectively analyzed: gender, age, pre- and postoperative hemoglobin and hematocrit level, duration of surgery, presence of thrombosis, number of removed and left nodes, number of bed-days, early and late postoperative complications, need for narcotic analgesics, follow-up period and time to return to normal daily activities. Results. The operation time was 16 (5–60) min in the ECHD and 22 (6–40) — in the conventional method group. Postoperative analgesics were used in 82 (78.8%) cases in the conventional treatment and in 29 (37.2%) cases in the ECHD group. The time required to return to normal daily activity was 6 (1–15) days in the ECHD and 7 (1–30) days in the conventional method group. Conclusions. The study found that ECHD outperformed the conventional method in duration of surgery, period of hospitalization, postoperative pain relief needs, postoperative bleeding as well as the time required to return to normal daily activity.
- Arslani N., Patrlj L., Rajkoviç Z. et al. (2012) A randomized clinical trial comparing Ligasure versus stapled hemorrhoidectomy. Surg. Laparosc. Endosc. Percutan. Tech., 22(1): 58–61.
- Bullard K.M., Rothenberg D.A. (2005) Colon, Rectum, and Anus. In: Brunicardi F.C. (Еd.) Swhwartz’s Principles of Surgery. 8th edn. McGraw Hill, New York, p. 1055–1117.
- Chung Y.C., Wu H.J. (2003) Clinical Experience of Sutureless Closed Hemorrhoidectomy with Ligasure. Dis. Colon. Rectum., 46: 87–92.
- Cohen Z. (1985) Symposium on outpatient anorectal procedures. Alternatives to surgical hemorrhoidectomy. Can. J. Surg., 28: 230–231.
- Ferguson J.A., Heaton J.R. (1959) Closed hemorrhoidectomy. Dis. Colon. Rectum., 2: 176–179.
- Filingeri V., Gravante G., Baldessari E. et al. (2004) Prospective randomized trial of submucosal hemorrhoidectomy with radiofrequency bistoury vs. conventional Parks’ operation. Techniq. Coloproctol., 8: 31–36.
- Gentile M., De Rosa M., Carbone G. et al. (2011) Ligasure Haemorrhoidectomy versus Conventional Diathermy for IV-Degree Haemorrhoids: Is It the Treatment of Choise? A Randomized, Clinical Trial. ISRN Gastroenterology.
- Ho Y.H., Cheong W.K., Tsang C. et al. (2000) Stapled hemorrhoidectomy-cost and effectiveness. Randomized, controlled trial including incontinence scoring, anorectal manometry, and endoanal ultrasound assessments at up to three months. Dis. Colon. Rectum., 43: 1666–1675.
- Kennedy J.S., Stranahan P.L., Taylor K.D., Chandler J.G. (1998) High-burst strength, feedback controlled bipolar vessel sealing. Surg. Endosc., 12: 876–878.
- Khanna R., Khanna S., Bhadani S. et al. (2010) Comparison of Ligasure Hemorrhoidectomy with Conventional Ferguson’s Hemorrhoidectomy. Indian. J. Surg., 72: 294–297.
- Mastakov M.Y., Buettner P.G., Ho Y.H. (2008) Updated meta-analysis of randomized controlled trials comparing conventional excisional haemorrhoidectomy with Ligasure for haemorrhoids. Tech. Coloproctol., 12: 229–239.
- Milito G., Cadeddu F., Muzi M.G. et al. (2010) Haemorrhoidectomy with Ligasure vs conventional excisional techniques: meta-analysis of randomized controlled trials. Colorectal. Dis., 12: 85–93.
- Milligan E.T.C., Naunton Morgan C., Jones L., Officer R. (1937) Surgical anatomy of the anal canal, and the operative treatment of hemorrhoids. Lancet, 230: 1119–1124.
- Nienhuijs S., de Hingh I. (2009) Conventional versus Ligasure hemorrhoidectomy for patients with symptomatic Hemorrhoids. Cochrane Database Syst. Rev., 21: CD006761.
- Peker K., İnal A., Güllü H. et al. (2013) Comparison of Vessel Sealing Systems with Conventional. Iranian. Red. Crescent. Med. J., 15: 488–496.
- Sayfan J., Becker A., Koltun L. (2001) Sutureless closed hemorrhoidectomy: a new technique. Ann. Surg., 234: 21–24.
- Tan K.Y., Zin T., Sim H.L. et al. (2008) Randomized clinical trial comparing LigaSure haemorrhoidectomy with open diathermyhaemorrhoidectomy. Tech. Coloproctol., 12: 93–97.