Randomized controlled study between suture ligation and radio wave ablation and suture ligation of grade III symptomatic hemorrhoidal disease.
OBJECTIVE
Suture ligation is a simple method to curb the hemorrhoids. The present study was conducted to determine the usefulness of suture ligation in third-degree hemorrhoids and to compare it with author's procedure of suture ligation coupled with hemorrhoidal ablation through radiowave.


METHODS
One hundred and twenty-four consecutive patients with grade III hemorrhoids requiring surgery were randomized into two groups. Half of them were treated by suture ligation, while the remaining patients underwent a radiowave ablation of hemorrhoids using a Ellman radiowave generator followed by suture ligation. A blinded observer evaluated postoperative pain scores, amount of analgesics consumed, and complications encountered. He also assessed recurrence of hemorrhoids after 1 year.


RESULTS
The postoperative pain score was significantly higher in the suture ligation group (3.4+/-0.2 vs. 2.2+/-0.1, p<0.005). The mean total analgesic dose and duration of pain control using analgesics were greater and longer for suture ligation group than radiowave group (29+/-4 vs. 23+/-3 tablets, and 15+/-3 days vs. 12+/-4 days, respectively; p<0.001). Complications were seen more frequently in radiowave group (22% vs.18%). At 1 year follow-up, the recurrence of hemorrhoids was more significant with the suture ligation group (five patients vs. one patient, p<0.05).


CONCLUSIONS
Suture ligation of hemorrhoids is a simple, cost-effective, and a convenient modality in treating third-degree hemorrhoids. The efficacy and postoperative comfort is further enhanced if the hemorrhoids are ablated with radiowave prior to ligating them.
Gupta
P J
PJ
Fine Morning Hospital and Research Center, Gupta Nursing Home, Laxminagar, Nagpur 440022, India. drpjg@yahoo.co.in
Heda
P S
PS
Kalaskar
S
S
D017115:Catheter Ablation / Q000009:adverse effects; D003710:Demography; D005260:Female; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008026:Ligation / Q000009:adverse effects; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D013537:Sutures / Q000009:adverse effects
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