Prospective, randomized, controlled trial of Starion vs Ligasure hemorrhoidectomy for prolapsed hemorrhoids.
OBJECTIVE
This study was designed to evaluate the efficacy and outcome of the Starion and Ligasure vessel sealing systems for sutureless hemorrhoidectomy.


METHODS
Sixty-four patients with Grades III and IV hemorrhoids were randomized into two groups: 1) Starion hemorrhoidectomy (32 patients), and 2) Ligasure hemorrhoidectomy (32 patients). The patient demographics, operative details, numbers of parenteral analgesic injections, postoperative pain scores (assessed by an independent assessor), operating time, intraoperative blood loss, hospital stay, early and delayed complications, and time off from work or normal activity were recorded. The patients were regularly followed-up at 1, 2, 4, 6, 8, and 12 weeks after surgery.


RESULTS
The mean blood loss, mean operating time, duration of hospital stay, and time off from work or normal activity were not significantly different between the two methods (all P > 0.05), except for a lower pain score (P = 0.032) and reduced numbers of parenteral analgesic injections (P < 0.001) in Starion hemorrhoidectomy. In addition, there were no differences in the early and delayed postoperative complications between the two methods (all P > 0.05). Unfortunately, two patients with symptomatic anal stenosis requiring treatment were encountered by Ligasure hemorrhoidectomy, but none by Starion hemorrhoidectomy.


CONCLUSIONS
Starion hemorrhoidectomy with submucosal dissection is a safe and effective procedure, comparable to Ligasure hemorrhoidectomy. Patients derive a short-term benefit of less pain and reduced parenteral analgesic use by Starion hemorrhoidectomy. The superiority of no cases complicated with symptomatic anal stenosis requiring treatment by Starion hemorrhoidectomy seems to offer a better therapeutic alternative for prolapsed hemorrhoids.
Wang
Jaw-Yuan
JY
Department of Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan.
Tsai
Hsiang-Lin
HL
Chen
Fang-Ming
FM
Chu
Koung Shing
KS
Chan
Hon-Man
HM
Huang
Che-Jen
CJ
Hsieh
Jan-Sing
JS
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006484:Hemorrhoids / Q000601:surgery*; D006489:Hemostatic Techniques / Q000295:instrumentation; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011391:Prolapse; D011446:Prospective Studies; D020127:Recovery of Function; D013536:Suture Techniques / Q000009:adverse effects / Q000295:instrumentation*