LigaSure Haemorrhoidectomy versus Conventional Diathermy for IV-Degree Haemorrhoids: Is It the Treatment of Choice? A Randomized, Clinical Trial

摘要

Introduction. Milligan-Morgan haemorrhoidectomyperformed with LigaSure system (LS) seems to be mainly effectivewhere a large tissue demolition is required. This randomized studyis designed to compare LigaSure haemorrohidectomy withconventional diathermy (CD) for treatment of IV-degreehaemorrhoids.Methods. 52 patients with IV-degreehaemorrhoids were randomized to two groups (conventional diathermyversus LigaSure haemorrhoidectomy). They were evaluated on the basisof the following main outcomes: mean operative time, postoperativepain, day of discharge, early and late complications. The time ofrecovery of work was also assessed. All patients had a minimumfollow-up of twelve months (range 12–24). All data werestatistically evaluated.Results. 27 patientswere treated by conventional diathermy, 25 by LigaSure. The meanoperative time was significantly shorter in LS, such aspostoperative pain, mainly lower on the third and fourthpostoperative day: moreover pain disappeared earlier in LS thanCD. The time off-work was shorter in LS, while there was nodifference in hospital stay and overall complications rate.Conclusions. LigaSure is an effective instrumentwhen a large tissue demolition is required. This study supportsits use as treatment of choice for IV degree haemorrhoids, even ifthe procedure is more expansive than conventional operation.