title: [Milligan-Morgan haemorrhoidectomy with ultrasonic scalpel].
abstract: BACKGROUND
  Milligan-Morgan haemorrhoidectomy is considered the best treatment for hemorrhoidal disease. Although this, many patients complaint post-operative pain that remain the worse complication. For this reason different are the trials performed in order to reduce his intensity. In this report we want to evaluate if the use of ultrasonic scalpel to perform Milligan-Morgan hemorrhoidectomy, compared with conventional surgery, could reduce post-operative pain.
  
  
  METHODS
  30 patients with III and IV degree of haemorrhoids were included in this study and divided in two groups. In the first group Milligan-Morgan haemorrhoidectomy was performed with conventional instruments, while in the second group the some procedure was performed with ultrasonic scalpel. The duration of intervention, time hospitalization, the time to open alvus to stools, the time to return to normal activity, the complications, pain and the amount of analgesic consumption were evaluated.
  
  
  RESULTS
  In the II group's patients, it was observed a reduced time to healing with reduced spread of necrosis and inflammatory pattern, associated with reduced post-operative pain and the lower analgesic consumption.
  
  
  CONCLUSIONS
  The use of ultrasonic scalpel to perform Milligan-Morgan haemorrhoidectomy, compared with conventional instruments, reduce post-operative pain making a more short time to healing and a precocious time to return to normal activity. For this reason we believe that the use of ultrasonic scalpel, although a more elevated costs, seems to be advantageous.
authors.affiliation: Università degli Studi di Palermo, Dipartimento di Discipline Chirurgiche ed Oncologiche, U.O. Di Chirurgia Generale, Endoscopica, Diagnostica ed Interventistica.
authors.forename: G
authors.initials: G
authors.lastname: Di Vita
authors.forename: R
authors.initials: R
authors.lastname: Patti
authors.forename: R
authors.initials: R
authors.lastname: Petrone
authors.forename: M
authors.initials: M
authors.lastname: Arcara
authors.forename: G
authors.initials: G
authors.lastname: Sieli
mesh_terms: D000328:Adult; D000368:Aged; D013505:Digestive System Surgical Procedures / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006484:Hemorrhoids / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014465:Ultrasonics