Kraemer Matthias, Parulava Tengis, Roblick Michael, Duschka Lothar, Müller-Lobeck Heinrich
Department of General Surgery/Coloproctology, St. Barbara-Klinik, Hamm-Heessen, Germany.
Dis Colon Rectum. 2005 Aug;48(8):1517-22. doi: 10.1007/s10350-005-0067-z.
It has been shown that for hemorrhoidal surgery both LigaSure and stapler cause less pain than diathermy or scissor dissection. This study has attempted to establish which of the less painful alternatives proves best in an unselected series of patients with hemorrhoidal disease.
Fifty patients were randomized to undergo stapling hemorrhoidopexy or LigaSure hemorrhoidectomy. Parameters investigated were pain (primary parameter), patient satisfaction with treatment, and recovery of personal activity. Other factors investigated were operative result, ease of handling, analgesic requirements, and postoperative course.
Both methods were found to be equivalent in all major aspects analyzed. Postoperative pain scores (P = 0.99), patient satisfaction (P = 1), and self-assessment of activity (P = 0.99) were almost identical in both groups of patients. Significant differences were found in none of the numerous factors investigated.
Both methods can be used safely and without major disadvantage for the patient regardless of stage and extent of hemorrhoidal disease.
已有研究表明，对于痔疮手术，LigaSure和吻合器造成的疼痛均比电灼或剪刀剥离术少。本研究试图确定在未经挑选的一系列痔疮病患者中，哪种疼痛较轻的方法效果最佳。
50例患者被随机分为接受吻合器痔上黏膜环切术或LigaSure痔切除术。所研究的参数包括疼痛（主要参数）、患者对治疗的满意度以及个人活动恢复情况。其他研究因素包括手术结果、操作的难易程度、镇痛需求和术后病程。
在所有分析的主要方面，两种方法被发现是等效的。两组患者的术后疼痛评分（P = 0.99）、患者满意度（P = 1）和活动自我评估（P = 0.99）几乎相同。在所研究的众多因素中均未发现显著差异。
无论痔疮病的分期和范围如何，这两种方法对患者而言都可安全使用且无重大弊端。
