This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Randomized clinical trial of Ligasure™ versus conventional diathermy for day‐case haemorrhoidectomy. BJS 2002; 89: 428-432.
Published: 5th November 2002
Authors: D. G. Jayne, I. Botterill, N. S. Ambrose, T. G. Brennan, P. J. Guillou, D. S. O'Riordain et al.
Background
Haemorrhoidectomy is frequently associated with postoperative pain and prolonged hospital stay. A new technique of haemorrhoidectomy using the Ligasure™ device suited to day‐case surgery is described. This technique was compared with conventional open diathermy haemorrhoidectomy.
Method
Forty patients with grade III or IV haemorrhoids were randomized to Ligasure™ (group 1) or conventional diathermy (group 2) haemorrhoidectomy. Operative details were recorded and patients recorded daily pain scores on a linear analogue scale. Follow‐up was at 1, 3, 6 and 12 weeks to evaluate complications, return to normal activity, ongoing symptoms and patient satisfaction.
Results
Reduced intraoperative blood loss (median (range) 0 (0–5) ml versus 20 (12–22) ml; P < 0·001) and a shorter operating time (10 (8–11) versus 20 (18–25) min; P < 0·001) was observed in group 1 compared with group 2. More patients in group 1 were discharged on the day of operation (18 of 20 versus 11 of 20; P < 0·05) and there was a trend towards lower postoperative pain scores on day 1 (group 1 median 5 (95 per cent confidence interval (c.i.) 2·6 to 6·8) versus group 2 7 (95 per cent c.i. 4·2 to 7·7); P = 0·36). There was no difference between the two groups in the degree of patient satisfaction or number of postoperative complications.
Conclusion
Ligasure™ diathermy may be used safely in the treatment of patients with grade III or IV haemorrhoids. It reduces intraoperative blood loss and operating time, and facilitates same‐day discharge. © 2002 British Journal of Surgery Society Ltd
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