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Erschienen in:
01.08.2007
Prospective, Randomized, Controlled Trial of Starion™ vs. Ligasure™ Hemorrhoidectomy for Prolapsed Hemorrhoids
Erschienen in: Diseases of the Colon & Rectum | Ausgabe 8/2007
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This study was designed to evaluate the efficacy and outcome of the Starion™ and Ligasure™ vessel sealing systems for sutureless hemorrhoidectomy.
Methods
Sixty-four patients with Grades III and IV hemorrhoids were randomized into two groups: 1) Starion™ hemorrhoidectomy (32 patients), and 2) Ligasure™ hemorrhoidectomy (32 patients). The patient demographics, operative details, numbers of parenteral analgesic injections, postoperative pain scores (assessed by an independent assessor), operating time, intraoperative blood loss, hospital stay, early and delayed complications, and time off from work or normal activity were recorded. The patients were regularly followed-up at 1, 2, 4, 6, 8, and 12 weeks after surgery.
Results
The mean blood loss, mean operating time, duration of hospital stay, and time off from work or normal activity were not significantly different between the two methods (all P > 0.05), except for a lower pain score (P = 0.032) and reduced numbers of parenteral analgesic injections (P < 0.001) in Starion™ hemorrhoidectomy. In addition, there were no differences in the early and delayed postoperative complications between the two methods (all P > 0.05). Unfortunately, two patients with symptomatic anal stenosis requiring treatment were encountered by Ligasure™ hemorrhoidectomy, but none by Starion™ hemorrhoidectomy.
Conclusions
Starion™ hemorrhoidectomy with submucosal dissection is a safe and effective procedure, comparable to Ligasure™ hemorrhoidectomy. Patients derive a short-term benefit of less pain and reduced parenteral analgesic use by Starion™ hemorrhoidectomy. The superiority of no cases complicated with symptomatic anal stenosis requiring treatment by Starion™ hemorrhoidectomy seems to offer a better therapeutic alternative for prolapsed hemorrhoids.