Surgical treatment for IV-degree hemorrhoids: LigaSure™ hemorroidectomy vs. conventional diathermy. A prospective, randomized trial

Minerva Chir. 2011 Jun;66(3):207-13.

Abstract

Aim: Milligan-Morgan operation is still considered the treatment of choice for IV-degree haemorrhoids: it is frequently associated with significant postoperative pain and prolonged hospital stay. Many instruments were conceived to reduce these complications, such as the LigaSure™ (LS) system, a combination of radiofrequency and pressure that seems mainly effective where a large tissue demolition is required. This randomized study is

Methods: Fifty-two patients with IV-degree hemorrhoids were randomly assigned to two different surgical treatments (conventional diathermy vs. LigaSure™ hemorrhoidectomy). They were evaluated on the basis of the following main outcomes: mean operative time, postoperative pain, day of discharge early and late complications. The time of recovery of work was also assessed. All patients had a minimum follow-up of twelve months (range 12-24). All data were statistically evaluated.

Results: Twenty-seven patients were treated by conventional diathermy, 25 by LigaSure™. The mean operative time was significantly shorter in LS, such as postoperative pain, mainly lower on the third and fourth postoperative day: moreover pain disappeared earlier in LS than CD. The time off-work was shorter in LS, while there was no difference in hospital stay and overall complications rate .

Conclusion: This randomized prospective controlled trial confirms, according to other large trials in literature , the benefits of the LigaSure™ hemorrhoidectomy over conventional diathermy when a large tissue demolition is required, supporting the use of this device as treatment of choice in IV degree hemorrhoids, even if the procedure is more expensive than conventional operation.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Catheter Ablation*
  • Diathermy*
  • Female
  • Follow-Up Studies
  • Hemorrhoids / classification
  • Hemorrhoids / surgery*
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Severity of Illness Index
  • Vascular Surgical Procedures / methods
  • Young Adult