Document Detail

Ligasure Precise vs. conventional diathermy for Milligan-Morgan hemorrhoidectomy: a prospective, randomized, multicenter trial.
MedLine Citation:
PMID:  18231834     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Milligan-Morgan hemorrhoidectomy using radiofrequency dissection (Ligasure) has been proposed instead of conventional diathermy in view of its potential benefits in terms of postoperative anal pain and better hemostatic control, but the medical literature is still controversial. This multicenter, randomized, controlled trial was designed to compare the outcomes between Ligasure and conventional diathermy hemorrhoidectomy in the Milligan-Morgan procedures in a sufficient number of patients. METHODS: Patients with Grades III and IV hemorrhoids were randomized to two groups: Ligasure hemorrhoidectomy and conventional diathermy. Postoperative anal pain was measured by the Visual Analog Scale (VAS) and the analgesia required. Postoperative complications, wound healing, and return to working activities also were evaluated as secondary outcomes. RESULTS: A total of 273 patients, well matched for age, gender, working activity and grade of hemorrhoids, were randomized to two groups: Ligasure 146, and diathermy 127. The severity of postoperative anal pain was significantly less in the Ligasure group when measured at least 12 hours after defecation (P < 0.01), whereas it was similar at the time of defecation. The Ligasure group had significantly lower requirements for painkiller pills. There were no significant differences in early and late complications. Return to work and normal activities was significantly faster in the Ligasure group. CONCLUSION: Ligasure hemorrhoidectomy is an effective procedure for Grades III and IV hemorrhoids and facilitates a faster return to work and normal activities by reducing postoperative pain.
D F Altomare; G Milito; R Andreoli; F Arcanà; N Tricomi; C Salafia; D Segre; G Pecorella; A Pulvirenti d'Urso; N Cracco; G Giovanardi; G Romano;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial     Date:  2008-01-30
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  51     ISSN:  1530-0358     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-05     Completed Date:  2008-07-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  514-9     Citation Subset:  IM    
Department of Emergency and Organ Transplantation, General Surgery Unit, University of Bari, Policlinico, piazza G. Cesare, 11, 70124, Bari, Italy.
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MeSH Terms
Hemorrhoids / therapy*
Ligation / instrumentation*
Middle Aged
Pain Measurement
Pain, Postoperative
Prospective Studies
Statistics, Nonparametric
Treatment Outcome
Wound Healing
A Infantino / ; C A Tonizzo / ; G Picardo / ; M Buonanno / ; G A Binda / ; A Di Pascale / ; G Logrieco / ; F Gilbertoni / ; P D Muzi / ; F Pezzolla / ; G Tegon /

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