A Randomized Clinical Trial Comparing Ligasure Versus Stapled Hemorrhoidectomy

Arslani, Nuhi; Patrlj, Leonardo; Rajković, Zoran; Papeš, Dino; Altarac, Silvio

doi:10.1097/sle.0b013e318247d966

Cited by 27 publications

(23 citation statements)

References 21 publications

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“…In SH group in our study post-operative pain was observed in slightly more number of patients, probably due to anal spasm, comparable results were observed by Basdanis G et al 1,4,7,8 Despite positioning the stapled line above dentate line and absence of external wound, pain was observed. In due course of time prolapsed haemorrhoids shrinked.…”

Section: Discussionsupporting

confidence: 77%

“…1,3,4,6,[8][9][10][11][12][13][14][15][16][17][18] Anal/rectal stenosis observed was about five times higher in EH group in spite of leaving islands of normal skin and mucosa to avoid stricture formation, which was managed conservatively. Recurrence, residual skin tags and prolapse were observed to be three times higher in SH group, comparable results were observed by Yang J et al [1][2][3][4][5] …”

Section: Discussionmentioning

confidence: 99%

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A comparative study of modern techniques of stapled versus enseal haemorrhoidectomy: a prospective randomized trial on 240 cases

Kochar

Singh

2016

Int Surg J

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Background: Increasing incidence of haemorrhoids in population consuming diet rich in calories, low in fibre, spicy food, tropical climate and other known factors has led to development of new techniques for haemorrhoid treatment. The aim of study is to compare pros and cons of haemorrhoidectomy with stapler v/s enseal. Methods: A prospective randomized trial was conducted on a total of 240 patients having 3rd and 4th degree haemorrhoids, divided into two groups of 120 each during 2012-2014 at NIMS Medical College and Hospital, Jaipur, India. Pre-operative complaints (bleeding P/R, rectal/perianal pain, mass coming out of anus), operative and postoperative outcomes, operative time, post-operative pain, bleeding, urinary retention, faecal/flatus incontinence, thrombosis of external haemorrhoids/perianal hematoma, anal/rectal stenosis, wound problems and recurrence were assessed. Results: Average operating time was 1.5 times in Stapler Haemorrhoidectomy(SH) v/s Enseal Haemorrhoidectomy (EH), average hospital stay, recovery time and total analgesics required during 5 POD was almost 0.5 in SH v/s EH. Post-operative complications like bleeding, urinary retention, faecal/flatus incontinence, anal discomfort, rectal/anal stenosis and wound infection were found significantly less in SH v/s EH. Residual skin tags prolapse and recurrence was almost three times in SH v/s EH. Kochar MP et al. Int Surg J. 2016 May;3(2) Both techniques are equally good, require less operating time, control post-operative bleeding, pain and prolapsed part of haemorrhoids and allow for early resuming of work. Conclusions METHODSA prospective randomized trial was conducted on a total of 240 patients having symptomatic 3 rd and 4 th degree haemorrhoids divided into two groups of 120 each. Group 'A' Stapler haemorrhoidopexy (SH) and Group 'B' Enseal haemorrhoidectomy (EH). All patients followed a fixed protocol. The operation was performed under either general anesthesia (78 patients i.e. 32.5%) or spinal/saddle block anesthesia (162 patients i.e. 67.5%) depending on anesthetist's advice or patient preference. A proctoclysis enema was given to all patients' 3-4hrs prior to surgery. All patients were operated in lithotomy position.In SH group PPH03 was used on 76 patients while HEM 3348 circular stapler was used on the remaining 44 patients. HEM 3348 having detachable anvil which provide good working space for applying purse string suture and having no side holes in casing of device as in PPH03, so traction on purse string is not possible that results into less pulling inside prolapsed haemorrhoids and rectal mucosa into device housing that ultimately gets excised. 30 seconds time was given before and after shoot of stapler that acts as temponade and haemostasis as well. Operating time was recorded from the time of anal dilator insertion to the application of endoanal dressing. An interrupted purse string suture was applied 2-3cm above the dentate line with prolene 2/0 on 38mm round body needle, before tightening it was checked by placing ...

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

A comparative study of modern techniques of stapled versus enseal haemorrhoidectomy: a prospective randomized trial on 240 cases

Kochar

Singh

2016

Int Surg J

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“…[3][4][5][6][7] Patients characteristics extracted from these trials are presented in Table 1. [3][4][5][6][7] Patients characteristics extracted from these trials are presented in Table 1.…”

Section: Resultsmentioning

confidence: 99%

Ligasure Versus Stapled Hemorrhoidectomy in the Treatment of Hemorrhoids

Chen¹,

Woo²,

Cui³

et al. 2014

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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The aim of this meta-analysis was to compare the outcomes of Ligasure hemorrhoidectomy and stapled hemorrhoidectomy for prolapsed hemorrhoids. Original studies in any language were searched from MEDLINE database, PubMed, Web of science and the Cochrane Library database, and Wangfang database. Randomized control trials that compared Ligasure hemorrhoidectomy with stapled hemorrhoidectomy were identified. Data were extracted independently for each study, and a meta-analysis was performed using fixed and random-effects models. Five trials including 397 patients met the inclusion criteria. Patients treated with Ligasure had a significantly shorter operative time compared with patients who underwent stapler techniques. The recurrence rate was higher in patients who underwent stapled hemorrhoidectomy. No statistically significant differences were observed in postoperative bleeding, urinary retention, difficult defecating, anal fissure, anal stenosis, incontinence, postoperative pain, return to normal activities, and hospital stay. Our meta-analysis shows that Ligasure is an effective instrument for hemorrhoidectomy, which results in shorter operation time and lower recurrence rate.

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“…1 About 5% of the general population has some degree of haemorrhoidal disease especially those elder than 40 years. 2 Haemorrhoids can be external or internal relative to dentate line. 3 Internal haemorrhoids are divided in to four grades by Goligher system.…”

Section: Introductionmentioning

confidence: 99%

Postoperative recovery; Stapled Hemorrhoidopexy versus Conventional haemorrhoidectomy.

Khan

Mahar

Adnan³

et al. 2020

TPMJ

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Conventional haemorrhoidectomy, a usual procedure for hemorrhoids in our set up have many short and long term complications. Some patients complained pain many weeks after surgery and are unable to do their routine work. Anal stenosis and recurrence are long term issues. There is need for some other procedure which can decrease postoperative pain and hospital stay. Objectives: To compare the postoperative recovery between stapled hemorrhoidopexy and conventional hemorrhoidectomy. Study Design: Randomized Clinical trial. Setting: Surgery Department of Nishtar Medical University Multan. Period: from 01-01-2018 to 31-12-2018. Material & Methods: Randomly 02 equal groups of the patients, A and B were made. Stapled hemorrhoidopexy (SH) and conventional haemorrhoidectomy was done in group A and B respectively. SPSS version 20 used for data analysis. Mean and standard deviation were used for quantitative variables including postoperative pain, age and hospital stay. Independent Student t test used for comparison of hospital stay and postoperative pain. Effect modifier including gender, age, duration and grade of hemorrhoids were controlled by stratification and Chi square test was applied. P value less than 0.05 was taken as significant. Results: Out of 60 patients, 32 were males and 28 females. In Group A (Stapled Hemorrhoidopexy), mean age was 37.37 + 6.36 years and 39.17 + 5.53 years in Group-B. Postoperative pain in Group A was 3.60 + 1.27 and 6.03 + 1.73 in Group B. Postoperative pain was significantly high in Group B (CH) and P value =0.000. Mean hospital stay was 0.90 + 0.48 days in Group A and 1.87 + 0.57 days in Group B with P value= 0.000. Conclusion: Stapled hemorrhoidopexy is associated with shorter hospital stay and decrease postoperative pain irrespective of age, sex and grade of the hemorrhoids.

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A Randomized Clinical Trial Comparing Ligasure Versus Stapled Hemorrhoidectomy

Cited by 27 publications

References 21 publications

A comparative study of modern techniques of stapled versus enseal haemorrhoidectomy: a prospective randomized trial on 240 cases

A comparative study of modern techniques of stapled versus enseal haemorrhoidectomy: a prospective randomized trial on 240 cases

Ligasure Versus Stapled Hemorrhoidectomy in the Treatment of Hemorrhoids

Postoperative recovery; Stapled Hemorrhoidopexy versus Conventional haemorrhoidectomy.

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