Open Hemorrhoidectomy With Ligasure™ Under Local or Spinal Anesthesia: A Comparative Study

Feo, Claudio F; Ninniri, Chiara; Tanda, Cinzia; Deiana, Giulia; Porcu, Alberto

doi:10.1177/00031348211038590

Cited by 4 publications

(2 citation statements)

References 23 publications

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“…In the last 50 years, new procedures have been developed to replace traditional surgical approaches for hemorrhoidal disease in order to improve patient satisfaction and minimize complications [16][17][18]. However, there has been no study to date comparing the outcomes of LH and LigaSure procedures in the treatment of hemorrhoidal disease.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the efficacy of LigaSure and laser for grade 2-3 hemorrhoids

Taşkin,

Özçetin

2023

J CLIN MED KAZ

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Aim: The aim of this study is to compare the efficacy of LigaSure and LH procedures in the treatment of grade 2-3 hemorrhoids. Material and methods: Demographic and clinical data of the patients were recorded retrospectively. A visual analogue scale (VAS) was used to evaluate the pain intensity of the patients after the procedure and a Likert-type scale was used to evaluate patient satisfaction surveys 6 months after the procedure. Results: Of the 66 patients, (mean age: 42.12±11.92 years, %72,7 male) 34 underwent LH procedure whereas 32 underwent LigaSure procedure. Spinal anesthesia was applied for 64 patients and general anesthesia was applied for 2 patients. Procedure time and time to return to work were significantly shorter in the LH group compared to the LigaSure group (900 vs. 1200 seconds, p<0.001, and 3.64±1.29 vs. 14.46±3.73 days, p<0.001). Late complications (abscess, relapse, pruritus, and seromucous discharge) were more common in the LH group, but the difference was not statistically significant (23.5% vs. 6.3%, p=0.08). VAS pain scores were significantly lower in the LH group (p<0.001). Although there was no significant difference between the treatment groups in terms of patient satisfaction, relapse was significantly less common in the LigaSure group (p=0.045). Conclusion: In patients with grade 2-3 hemorrhoids, LH may be preferred over LigaSure due to greater patient comfort, higher satisfaction rates, and fewer early complications. However, close follow-up of these patients is important due to the higher incidence of late complications with LH.

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Section: Discussionmentioning

confidence: 99%

Comparison of the efficacy of LigaSure and laser for grade 2-3 hemorrhoids

Taşkin,

Özçetin

2023

J CLIN MED KAZ

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“…Anorectal diseases are common and include internal, external, and mixed hemorrhoids ( 1 ). Treatment for hemorrhoids patient is usually determined by preoperative clinical evaluation, and surgery is necessary for most symptomatic Grade III and IV patients ( 2 , 3 ).…”

Section: Introductionmentioning

confidence: 99%

Effect of single spinal anesthesia with two doses ropivacaine on urinary retention after hemorrhoidectomy in male patients

et al. 2023

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BackgroundAnorectal diseases are common in the population and include internal, external, and mixed hemorrhoids. Although hemorrhoid surgery is a brief operation, anesthesia, anesthetic drugs, drug concentrations, and anesthesia level control are closely related to postoperative uroschesis. For hemorrhoid surgery, a single spinal block with ropivacaine is commonly used that blocks the S2-S4 parasympathetic nervous system, which in turn governs the voiding reflex, causing postoperative urinary retention; this affects the recovery of patients. This study was performed to investigate the effects of two doses ropivacaine that provided satisfactory analgesia and muscle relaxation and inhibited adverse reflexes on urinary retention after hemorrhoidectomy.MethodsThe study included 200 male patients who underwent anorectal surgery with American Society of Anesthesiologists (ASA) grade I–II single elective spinal anesthesia between March 2021 and March 2022. Patients were randomly assigned to 2 groups using a random number table: Group A (n = 100) received 10 mg 0.5% ropivacaine (1.5 ml 1% ropivacaine + 1.5 ml 10% glucose = 3 ml), and Group B (n = 100) received 15 mg 0.5% ropivacaine (1.5 ml 1% ropivacaine + 1.5 ml 10% glucose = 3 ml).ResultsThe anal sphincter exhibited good relaxation, and no obvious traction pain or significant difference in the time of muscle strength recovery was observed between the 10 mg and 15 mg 0.5% ropivacaine groups (P > 0.05). The 10 mg 0.5% ropivacaine group had shorter time of micturition exceeding 100 ml and lower voiding International Prostate Symptom Score than the 15 mg 0.5% ropivacaine group (P < 0.01).ConclusionsSingle spinal anesthesia with 10 mg 0.5% ropivacaine not only provides satisfactory anesthetic effect for hemorrhoidectomy but also has less influence on postoperative uroschesis and is worthy of clinical application.Trial registrationThe study was registered in the Chinese Clinical Trial Registry (http://www.chictr.org.cn; identifier: ChiCTR2,100,043,686) on February 27, 2021.

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Minimally invasive laser technologies in the surgical treatment of hemorrhoidal disease: problems and prospects (literature review)

Yartseva,

Kornev,

Naumov

et al. 2023

Surgeon

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Based on the literature data, the article reviews the latest advances in the surgical treatment of patients with hemorrhoids. The methods of historical significance, as well as current surgeries are analyzed.The literature review focuses on laser technologies, in particular, laser hemorrhoidoplasty. The paper considers the historical aspects of the development of this approach in proctology, the main surgical techniques, indications and contraindications, possible intra- and postoperative complications, among which the most common are intraoperative bleeding, delayed bleeding, and pain syndrome. The analysis of clinical efficacy and the structure of recurrences and adverse outcomes are presented. Different regimes of laser exposure are analyzed as well. According to the literature data, laser hemorrhoidoplasty is a relatively clinically effective and safe minimally invasive surgical intervention, characterized by short postoperative rehabilitation and a low number of complications. Laser hemorrhoidoplasty is characterized by a low severity of pain syndrome both during the intervention and in the postoperative period. The high economic efficiency of the considered surgical intervention was noted. Meanwhile, the question of the optimal dosing and parameters of the laser energy used in the course of laser hemorrhoidoplasty remains open and should be answered in the upcoming clinical and experimental studies.

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Open Hemorrhoidectomy With Ligasure™ Under Local or Spinal Anesthesia: A Comparative Study

Cited by 4 publications

References 23 publications

Comparison of the efficacy of LigaSure and laser for grade 2-3 hemorrhoids

Comparison of the efficacy of LigaSure and laser for grade 2-3 hemorrhoids

Effect of single spinal anesthesia with two doses ropivacaine on urinary retention after hemorrhoidectomy in male patients

Minimally invasive laser technologies in the surgical treatment of hemorrhoidal disease: problems and prospects (literature review)

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