title: Ligasure, Harmonic Scalpel versus conventional diathermy in excisional haemorrhoidectomy: a randomized controlled trial.
abstract: BACKGROUND
  This study was designed to compare the surgical outcomes of haemorrhoidectomy performed by the Ligasure, Harmonic Scalpel with that performed by the conventional diathermy.
  
  
  METHODS
  A total of 180 patients were randomized to Ligasure, Harmonic Scalpel and diathermy haemorrhoidectomy, 60 patients for each group. The operative time, post-operative pain scores, parenteral analgesic requirements in the first 24 h, post-operative complications and wound healing rates were documented.
  
  
  RESULTS
  The median operative time was 8 min (range, 7-18) for the Ligasure and Harmonic Scalpel groups and 18 min (range, 15-21) for the diathermy group (P < 0.001). Throughout the first post-operative week, the daily median pain score was lower in the Ligasure and Harmonic Scalpel groups than in the diathermy group (P < 0.001). The median number of analgesic ampoules during the first 24 h post-operatively was lower in the Ligasure and Harmonic Scalpel groups (P < 0.001). There was no statistically significant difference in the incidence of post-operative complications. At 6 weeks post-operation, more patients in the Ligasure and Harmonic Scalpel groups had complete healing of wounds (P = 0 < 0.001).
  
  
  CONCLUSIONS
  Ligasure and Harmonic Scalpel provide a superior alternative to conventional diathermy in haemorrhoidectomy with no difference between them in reducing the operative time, post-operative pain, analgesic requirements during the first 24 h and time to complete healing of wounds.
authors.affiliation: Department of Surgery, Medical Research Institute, Alexandria University, Alexandria, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Talha
authors.affiliation: Department of Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
authors.forename: Samer
authors.initials: S
authors.lastname: Bessa
authors.affiliation: Department of Biostatistics, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
authors.forename: Moataza
authors.initials: M
authors.lastname: Abdel Wahab
mesh_terms: D000328:Adult; D003972:Diathermy / Q000379:methods*; D005260:Female; D061865:Hemorrhoidectomy / Q000295:instrumentation* / Q000379:methods*; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008026:Ligation / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
keywords: Harmonic Scalpel; Ligasure; diathermy; haemorrhoidectomy; haemorrhoids