Comparison of methods of automatic bipolar sealing and monopolar coagulation in the surgical treatment of hemorrhoids in patients with diabetes

Abstract

Comparison of LigaSure and traditional methods of surgical treatment of III and IV degree hemorrhoids in patients with diabetes mellitusHemorrhoids are submucosal nodules in the anal canal that contain venules, arterioles, and smooth muscle fibers. Hemorrhoidal disease is registered in approximately 5 % of the total population, especially after 40 years. Treatment is indicated only in symptomatic cases. These symptoms include pain, itching, bleeding, thrombosis and hemorrhoidal prolapse.Aim — to compare the clinical results of he­­mor­rhoidectomy using the electrocoagulation he­mostatic device LigaSure and the traditional Milligan—Morgan method in patients with diabetes mellitus. Materials and methods. The study included 65 patients of both genders aged 18—78 years with stage 3 and 4 hemorrhoids, who underwent hemor­rhoidec­tomy: from them, 33 subject were operated with LigaSure (the main group), and 32 patients with traditional Milligan—Morgan method (control group). The following patients’ data were analyzedretrospec­tively:gender, age, pre- and postoperative hemoglobin and hematocritlevels, surgery duration, the presence of thrombosis, the number of removed and residual hemorrhoids, hospitalization duration, early and late postoperative complications, the need for narcotic analgesics, the observationalperiod, and the time to return to normal daily activity. Results. The mean surgery duration was 16 (6—45) min in the study group and 21 (7—43) min in the control group. Narcotic analgesics in the postoperative period were used in 17 (53.1 %) patients in the control group and were not used in the study group. The timerequired for return to the normal daily activity was 6 (2—15) days in the study group and 8 (2—30) days in the control group. Conclusions. It has been shown that LigaSure gave betterresults of hemorrhoidectomy versus traditional methods in patients with diabetes mellitus in terms of surgery duration, hospitalizationperiod, postoperative pain relief needs, risk of postoperative bleeding, and time required to return to normal daily activity.