Efficacy of Ligasure(TM) in a Hemorrhoidectomy: Comparison with Semi-open Hemorrhoidectomy.
- Author:
Hae Hyeon SUH
1
Author Information
1. Coloproctology Clinic, Suhgwang Hospital, Gwangju, Korea. suhhh@korea.com
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Ligasure(TM);
Hemorrhoids/surgery;
Diathermy;
Surgical procedures;
Treatment outcome
- MeSH:
Analgesics;
Collagen;
Constriction, Pathologic;
Diathermy;
Elastin;
Freezing;
Hemorrhage;
Hemorrhoidectomy*;
Hemorrhoids;
Humans;
Length of Stay;
Mucous Membrane;
Prospective Studies;
Skin;
Treatment Outcome;
Urinary Catheterization;
Urinary Catheters;
Urinary Retention;
Welding;
Wound Infection
- From:Journal of the Korean Society of Coloproctology
2003;19(5):271-275
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Ligasure(TM) is a feedback-controlled bipolar diathermy originally devised to seal vessels and developed to weld tissue bundles. The tissue fusion mechanism consists of melting collagen and elastin, and the tissue welding property of Ligasure(TM) can be used in a hemorrhoidectomy. To confirm the efficacy of Ligasure(TM) in hemorrhoidectomies, I compared it with the conventional semi-open method. METHODS: One hundred patients with grade III or IV hemorrhoids were randomly assigned to the Ligasure(TM) (n=50) or the conventional semi-open (n=50) hemorrhoidectomy group. The operation time, the postoperative analgesic requirement, the hospital stay, the time to return to normal life, and complications were prospectively recorded and analyzed. RESULTS: There was no difference in sex and age between the two groups. The operation time was markedly shorter in the Ligasure(TM) group than semi-open group (10.8+/-4.0 versus 23.7+/-5.2 min; P<0.001). Although the hospital stay was not statistically different, the time to return to the normal life was shorter in the Ligasure(TM) group (9.5+/-3.8 versus 12.7+/-4.0 days; P<0.05). The requirement for postoperative analgesics within 48 hours (nalbuphine, 5mg) was not significantly different. In each group, an urinary retention was noted and treated with urinary catheterization. In Ligasure(TM) group, an anal stenosis was developed and was successfully treated with advancement flap surgery. In each group a secondary bleeding and a skin tag were noted. There was no wound infection or incontinence. CONCLUSIONS: Ligasure(TM) hemorrhoidectomy reduces the operation time and the time to return to the normal life. If anal stenosis is to be prevented, careful attention is required to preserve the anal skin and mucosa. Ligasure(TM) is simple to use and is useful in the treatment of patients with grade III or IV hemorrhoids.
