Erschienen in:
01.02.2005 | Original Contributions
A Double-Blind, Randomized Trial Comparing LigasureTM and Harmonic ScalpelTM Hemorrhoidectomy
verfasst von:
S. Y. Kwok, F.R.A.C.S., F.R.C.S. (Edinb.), C. C. Chung, F.R.C.S. (Edinb.), K. K. Tsui, M.R.C.S. (Edinb.), M. K. W. Li, F.R.C.S. (Engl.), F.R.C.S. (Edinb.)
Erschienen in:
Diseases of the Colon & Rectum
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Ausgabe 2/2005
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PURPOSE
The major problem after hemorrhoidectomy is postoperative pain. New techniques have been evolved to circumvent this problem. The present study was conducted to compare the outcomes of LigasureTM hemorrhoidectomy and Harmonic ScalpelTM hemorrhoidectomy.
METHODS
This study was a double-blind, randomized controlled trial. Patients with Grade 3 and 4 hemorrhoids admitted for hemorrhoidectomy were selected and randomized into two groups: 1) LigasureTM hemorrhoidectomy or 2) Harmonic ScalpelTM hemorrhoidectomy. The primary outcomes measured were the analgesic requirement and the postoperative pain score (assessed by an independent assessor). Secondary outcome criteria included the operating time, blood loss, hospital stay, patient satisfaction score, and early and late complications.
RESULTS
Forty-nine patients were randomized into two groups (LigaSureT 24, Harmonic ScalpelT 25). Two patients were lost to follow-up, leaving 47 patients (LigaSureT 24, Harmonic ScalpelT 23) available for final analysis. The age and gender distribution were comparable. The postoperative pain score (median 2.6 vs. 4.8, P < 0.001) and postoperative oral analgesic (Dologesicreg) requirement (median 5 vs. 13, P = 0.001) were significantly less in the LigaSureT group. The operating time (median 11 vs. 18 minutes, P < 0.001) was significantly less in the LigaSureT group. The hospital stay, patient satisfaction score, percentage of patients requiring pethidine injection, percentage of patients with first bowel movement on or before the first postoperative day, and complication rates were similar between the two groups.
CONCLUSIONS
LigasureTM hemorrhoidectomy reduces the postoperative pain and operating time compared to the Harmonic ScalpelTM hemorrhoidectomy. It is a safe, effective procedure for treating Grade 3 and 4 hemorrhoids