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Haemorrhoidectomy: randomised controlled clinical trial of Ligasure compared with Milligan-Morgan operation
Carlos Vara Thorbeck1, Manuel Felices Montes
1Surgery Department, Hospital Clínico Universitario Virgen de la Victoria, Malaga, Spain.
Objective:
To evaluate the efficacy of the Ligasure system in the management of haemorrhoids.
Design:
Unblinded randomised clinical trial.
Setting:
Teaching hospital, Spain.
Patients:
112 patients with third and fourth degree haemorrhoids.
Interventions:
For 56 patients we used Ligasure system and a variant of Milligan and Morgan's technique. For the other 56, we used the traditional technique.
Main Outcome Measures:
Postoperative pain.
Results:
Operating times varied from 100 seconds for each haemorrhoidal cushion with Ligasure system to the 313 seconds by the traditional technique. The blood loss was not quantifiable in patients operated on with Ligasure. Pain was scored on a visual analogue scale. In the Ligasure group, the mean scores were 4.9 (immediate postoperative period) and 2.3 (24 hours later). In the other group, the scores were 7.8 and 6.9. These differences were significant.
Conclusion:
Haemorrhoidectomy using Ligasure as a technical variant of Milligan and Morgan's technique has important advantages.