title: Surgical treatment of haemorrhoidal disease with CO2 laser and Milligan-Morgan cold scalpel technique.
abstract: OBJECTIVE
  To prospectively compare immediate postoperative results of the surgical treatment of haemorrhoidal disease (HD) by Milligan-Morgan technique using either the CO(2) laser or cold scalpel.
  
  
  METHODS
  Forty patients with grade III/IV HD were prospectively randomized to undergo surgical treatment (Milligan-Morgan) using either the CO(2) laser (group A) or the cold scalpel method (group B). Data were compared regarding postoperative pain, complications, healing time, return to normal activity and patient satisfaction. Patients were blinded to treatment method until the completion of the study. Postoperative outcomes were assessed by patient questionnaire and outpatient follow-up visits. Pain was assessed by Visual Analogue Scale and analgesic consumption.
  
  
  RESULTS
  Twenty patients were randomized into each group and were comparable relative to mean age, gender and grade of HD. There were no statistically significant differences regarding postoperative pain measured (P =0.17) or consumption of oral (P = 0.741) and parenteral analgesics (P = 0.18) between the two groups. Mean pain score at the first bowel movement was significantly higher in group A (P = 0.035), although the use of analgesics was similar in both the groups. There were no differences regarding complications, mean healing time, return to normal activities and patient satisfaction.
  
  
  CONCLUSIONS
  There were no differences in the immediate results after Milligan-Morgan haemorrhoidectomy using either the CO(2) laser or cold scalpel regarding postoperative pain, complications, healing time, return to normal activities or patient satisfaction.
authors.affiliation: Department of Digestive Surgery, University of Sao Paulo, Sao Paulo, Brazil. videolap@terra.com.br
authors.forename: L C
authors.initials: LC
authors.lastname: Pandini
authors.forename: S C
authors.initials: SC
authors.lastname: Nahas
authors.forename: C S R
authors.initials: CS
authors.lastname: Nahas
authors.forename: C F S
authors.initials: CF
authors.lastname: Marques
authors.forename: C W
authors.initials: CW
authors.lastname: Sobrado
authors.forename: D R
authors.initials: DR
authors.lastname: Kiss
mesh_terms: D013505:Digestive System Surgical Procedures / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006484:Hemorrhoids / Q000473:pathology / Q000601:surgery*; D006801:Humans; D053685:Laser Therapy / Q000379:methods; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology*; D017060:Patient Satisfaction; D011446:Prospective Studies; D013525:Surgical Instruments