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Ligasure Precise vs. conventional diathermy for Milligan-Morgan hemorrhoidectomy: a prospective, randomized, multicenter trial.
Dis Colon Rectum. 2008 May; 51(5):514-9.DC

Abstract

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.

Authors+Show Affiliations

Department of Emergency and Organ Transplantation, General Surgery Unit, University of Bari, Policlinico, piazza G. Cesare, 11, 70124, Bari, Italy. altomare@clichiru.uniba.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

18231834

Citation

Altomare, D F., et al. "Ligasure Precise Vs. Conventional Diathermy for Milligan-Morgan Hemorrhoidectomy: a Prospective, Randomized, Multicenter Trial." Diseases of the Colon and Rectum, vol. 51, no. 5, 2008, pp. 514-9.
Altomare DF, Milito G, Andreoli R, et al. Ligasure Precise vs. conventional diathermy for Milligan-Morgan hemorrhoidectomy: a prospective, randomized, multicenter trial. Dis Colon Rectum. 2008;51(5):514-9.
Altomare, D. F., Milito, G., Andreoli, R., Arcanà, F., Tricomi, N., Salafia, C., Segre, D., Pecorella, G., Pulvirenti d'Urso, A., Cracco, N., Giovanardi, G., & Romano, G. (2008). Ligasure Precise vs. conventional diathermy for Milligan-Morgan hemorrhoidectomy: a prospective, randomized, multicenter trial. Diseases of the Colon and Rectum, 51(5), 514-9. https://doi.org/10.1007/s10350-007-9171-6
Altomare DF, et al. Ligasure Precise Vs. Conventional Diathermy for Milligan-Morgan Hemorrhoidectomy: a Prospective, Randomized, Multicenter Trial. Dis Colon Rectum. 2008;51(5):514-9. PubMed PMID: 18231834.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ligasure Precise vs. conventional diathermy for Milligan-Morgan hemorrhoidectomy: a prospective, randomized, multicenter trial. AU - Altomare,D F, AU - Milito,G, AU - Andreoli,R, AU - Arcanà,F, AU - Tricomi,N, AU - Salafia,C, AU - Segre,D, AU - Pecorella,G, AU - Pulvirenti d'Urso,A, AU - Cracco,N, AU - Giovanardi,G, AU - Romano,G, AU - ,, Y1 - 2008/01/30/ PY - 2007/03/19/received PY - 2007/08/25/accepted PY - 2007/06/16/revised PY - 2008/1/31/pubmed PY - 2008/7/2/medline PY - 2008/1/31/entrez SP - 514 EP - 9 JF - Diseases of the colon and rectum JO - Dis Colon Rectum VL - 51 IS - 5 N2 - 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. SN - 1530-0358 UR - https://www.unboundmedicine.com/medline/citation/18231834/Ligasure_Precise_vs__conventional_diathermy_for_Milligan_Morgan_hemorrhoidectomy:_a_prospective_randomized_multicenter_trial_ L2 - http://link.springer.com/article/10.1007/s10350-007-9171-6 DB - PRIME DP - Unbound Medicine ER -