ABSTRACT
OBJECTIVE: To prospectively compare immediate postoperative results of the surgical treatment of haemorrhoidal disease (HD) by Milligan-Morgan technique using either the CO(2) laser or cold scalpel. METHODS: Forty patients with grade III/IV HD were prospectively randomized to undergo surgical treatment (Milligan-Morgan) using either the CO(2) laser (group A) or the cold scalpel method (group B). Data were compared regarding postoperative pain, complications, healing time, return to normal activity and patient satisfaction. Patients were blinded to treatment method until the completion of the study. Postoperative outcomes were assessed by patient questionnaire and outpatient follow-up visits. Pain was assessed by Visual Analogue Scale and analgesic consumption. RESULTS: Twenty patients were randomized into each group and were comparable relative to mean age, gender and grade of HD. There were no statistically significant differences regarding postoperative pain measured (P =0.17) or consumption of oral (P = 0.741) and parenteral analgesics (P = 0.18) between the two groups. Mean pain score at the first bowel movement was significantly higher in group A (P = 0.035), although the use of analgesics was similar in both the groups. There were no differences regarding complications, mean healing time, return to normal activities and patient satisfaction. CONCLUSION: There were no differences in the immediate results after Milligan-Morgan haemorrhoidectomy using either the CO(2) laser or cold scalpel regarding postoperative pain, complications, healing time, return to normal activities or patient satisfaction.
Subject(s)
Digestive System Surgical Procedures/instrumentation , Digestive System Surgical Procedures/methods , Hemorrhoids/surgery , Pain, Postoperative/etiology , Female , Hemorrhoids/pathology , Humans , Laser Therapy/methods , Male , Middle Aged , Pain, Postoperative/diagnosis , Patient Satisfaction , Prospective Studies , Surgical InstrumentsABSTRACT
An evaluation of the results of the Brazilian experience in colorectal laparoscopic procedures in a multicenter prospective protocol done by the Brazilian Society of Colo-Proctology is presented. From December 1991 to August 1998, 1,161 patients (583 men and 578 women; mean age, 49.8 years), were operated on laparoscopically. Most of the procedures (40.5%) were for cancer, and the most common procedure was anterior resection (22.5%). The mean operative time was 189 minutes (3.1 hours). There were 42 (3.6%) perioperative complications; visceral injuries were the most common (1.4%). Conversions occurred in 122 (10.5%) cases. There were 148 (12.7%) postoperative complications; wound infections were the most common (5.2%). A liquid diet was started at a mean time of 1.4 days after the operation, and the mean hospitalization period was 6.4 days.
