Prospective, randomized study: proximate PPH stapler vs. LigaSure for hemorrhoidal surgery.
OBJECTIVE
It has been shown that for hemorrhoidal surgery both LigaSure and stapler cause less pain than diathermy or scissor dissection. This study has attempted to establish which of the less painful alternatives proves best in an unselected series of patients with hemorrhoidal disease.


METHODS
Fifty patients were randomized to undergo stapling hemorrhoidopexy or LigaSure hemorrhoidectomy. Parameters investigated were pain (primary parameter), patient satisfaction with treatment, and recovery of personal activity. Other factors investigated were operative result, ease of handling, analgesic requirements, and postoperative course.


RESULTS
Both methods were found to be equivalent in all major aspects analyzed. Postoperative pain scores (P = 0.99), patient satisfaction (P = 1), and self-assessment of activity (P = 0.99) were almost identical in both groups of patients. Significant differences were found in none of the numerous factors investigated.


CONCLUSIONS
Both methods can be used safely and without major disadvantage for the patient regardless of stage and extent of hemorrhoidal disease.
Kraemer
Matthias
M
Department of General Surgery/Coloproctology, St. Barbara-Klinik, Hamm-Heessen, Germany. mkraemer@barbaraklinik.de
Parulava
Tengis
T
Roblick
Michael
M
Duschka
Lothar
L
Müller-Lobeck
Heinrich
H
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use; D003672:Defecation / Q000502:physiology; D004564:Electrocoagulation / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011446:Prospective Studies; D013528:Surgical Staplers; D017792:Surgical Stapling; D016896:Treatment Outcome
D000700:Analgesics