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Randomized, prospective trial of direct current versus bipolar electrocoagulation for bleeding internal hemorrhoids
R Yang1, B Migikovsky, J Peicher
1Division of Gastrointestinal and Liver Diseases, University of Southern California School of Medicine, Los Angeles 90033.
Gastrointestinal Endoscopy
|November 1, 1993
Summary
Direct current electrocoagulation for bleeding internal hemorrhoids caused more pain and longer sessions than bipolar electrocoagulation. Both treatments showed high success rates, but bipolar electrocoagulation led to more ulcerations.
Area of Science:
- Gastroenterology
- Colorectal Surgery
Background:
- Internal hemorrhoids are a common condition.
- Standard medical therapy is often insufficient for severe or persistent bleeding.
Purpose of the Study:
- To compare the efficacy and safety of direct current versus bipolar electrocoagulation for treating internal hemorrhoids unresponsive to medical therapy.
Main Methods:
- Fifty patients with bleeding internal hemorrhoids were randomized to receive direct current or bipolar electrocoagulation.
- Outcomes assessed included treatment duration, procedural pain, post-procedure pain, rectal ulcerations, and success rates.
Main Results:
- Direct current electrocoagulation sessions were significantly longer (8.8 min vs. 0.1 min) and associated with more procedural pain leading to therapy termination (20% vs. 0%).
- Bipolar electrocoagulation resulted in more post-treatment rectal ulcerations (24% vs. 4%).
- Success rates were high for both: 88% for direct current and 92% for bipolar electrocoagulation.
Conclusions:
- Both direct current and bipolar electrocoagulation are effective treatments for refractory bleeding internal hemorrhoids.
- Bipolar electrocoagulation may be preferred due to shorter treatment times and less procedural pain, despite a higher rate of rectal ulcerations.