27 research outputs found
THE TREATMENT OF SECOND DEGREE HAEMORRHOIDS BY INJECTION, RUBBER BAND LIGATION, MAXIMAL ANAL DILATATION, AND HAEMORRHOIDECTOMY: A PROSPECTIVE CLINICAL TRIAL
Comparison of Ligasure Hemorrhoidectomy with Conventional Fergusonās Hemorrhoidectomy
Conventional hemorrhoidectomy for grade III and IV hemorrhoids is a tedious procedure associated with significant morbidity and a prolonged convalescence. We compared Ligasureā¢ hemorrhoidectomy with conventional āclosedā Fergusonās hemorrhoidectomy for the treatment of grade III and IV hemorrhoids. Forty-eight consecutive patients of grade III and IV hemorrhoids were randomized to either the Ligasureā¢ hemorrhoidectomy (28 patients) or Fergusonās hemorrhoidectomy (20 patients). The hemorrhoidal predicle was coagulated with Ligasureā¢ in the Ligasureā¢ group and transfied with 2/0 chromic catgut in Fergusonās method. In comparison with Fergusonās method, Ligasureā¢ hemorrhoidectomy had a shorter operating time (29 vs 12.5Ā min), less blood loss (22 vs 11.5Ā ml), less post operative pain as measured on VAS scale and less postoperative complications including hemorrhage (10% vs 3.5%), urinary retention (10% vs 3.5%) and wound breakdown (20% vs 14%). The submucosal dissection technique with Ligasureā¢ coagulation of the hemorrhoidal pedicle is safe and effective. The blood vessels and tissue are reduced to a wafer thin seal with good hemostasis. Suturing is not required as the mucosal tissue over the pedicle is sealed off with the current. There is minimal lateral spread of either thermal or electrical energy. The external components of the hemorrhoids can also be treated at the same time. Because of its ease of use and less postoperative pain and complication Ligasureā¢ hemorrhoidectomy can be preformed as a day-care procedure