Document Detail


LigaSure hemorrhoidectomy versus stapled Hemorrhoidopexy: a prospective, randomized clinical trial.
MedLine Citation:
PMID:  20628280     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: This study was designed to compare the outcome of LigaSure hemorrhoidectomy and stapled hemorrhoidopexy for prolapsed hemorrhoids. METHODS: Consecutive patients with grade III or IV hemorrhoids were randomly assigned to undergo either LigaSure hemorrhoidectomy or stapled hemorrhoidopexy. Data on patient demographic and clinical characteristics, operative details, postoperative pain score on a visual analog scale, number of parenteral analgesic injections, duration of hospital stay, and time to return to work were all prospectively collected. Postoperative complications and recurrence of prolapse were also recorded. Patients were regularly followed for a total period of 12 months. RESULTS: A total of 68 patients completed the study (34 per group). Patient demographic and clinical characteristics were similar in the 2 groups. No significant differences between LigaSure hemorrhoidectomy and stapled hemorrhoidopexy were observed in mean operating time, postoperative pain score, number of parenteral analgesic injections, duration of hospital stay, or time to return to work. The groups were also similar regarding postoperative complications, except that at 4 weeks postoperatively, residual prolapse was observed in 8 patients (23.5%) in the stapled hemorrhoidopexy group vs. 2 patients (5.9%) in the LigaSure group (P = .040). Rate of recurrence of prolapse at 1 year was higher with stapled hemorrhoidopexy (4 patients, 11.8%) than with the LigaSure procedure (1 patient, 2.9%), but the difference was not significant (P = .163). CONCLUSIONS: LigaSure hemorrhoidectomy and stapled hemorrhoidopexy yield comparable good results, with a short operative time and minimal side effects in the treatment of grade III and IV hemorrhoids, but with a lower rate of residual prolapse for the LigaSure procedure. Both procedures offer low levels of postoperative pain and therefore are excellent therapeutic options for prolapsed grade III and IV hemorrhoids. A larger controlled study is needed to reach solid conclusions regarding risk of postoperative recurrence of hemorrhoidal prolapse.
Authors:
Mahmoud F Sakr; Mohamed M Moussa
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  53     ISSN:  1530-0358     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-14     Completed Date:  2010-09-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1161-7     Citation Subset:  IM    
Affiliation:
Department of Surgery, Faculty of Medicine, University of Alexandria, Ramleh Station, Alexandria, Egypt. mah_sakr@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Follow-Up Studies
Hemorrhoids / surgery*
Humans
Ligation / instrumentation
Male
Middle Aged
Pain Measurement
Pain, Postoperative / diagnosis
Prospective Studies
Recurrence / prevention & control
Suture Techniques / instrumentation*
Sutures*
Treatment Outcome
Vascular Surgical Procedures / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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