Randomized controlled study between suture ligation and radio wave ablation and suture ligation of grade III symptomatic hemorrhoidal disease

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Abstract

Purpose: 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. Materials and 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). Conclusion: 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. © Springer-Verlag 2008.

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Gupta, P. J., Heda, P. S., & Kalaskar, S. (2009). Randomized controlled study between suture ligation and radio wave ablation and suture ligation of grade III symptomatic hemorrhoidal disease. International Journal of Colorectal Disease, 24(4), 455–460. https://doi.org/10.1007/s00384-008-0579-9

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