Study on LigaSure™ Haemorrhoidectomy as a Daycare Procedure

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Journal name: The Malaysian Journal of Medical Sciences
Original article title: A Prospective Interventional Study on LigaSureTM Haemorrhoidectomy as a Daycare Procedure
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:

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Author:

Abdel Latif K Elnaim, Shareef Musa, Michael Pak-Kai Wong, Ismail Sagap


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The Malaysian Journal of Medical Sciences:

(A peer-reviewed, open-access journal)

Full text available for: A Prospective Interventional Study on LigaSureTM Haemorrhoidectomy as a Daycare Procedure

Year: 2021 | Doi: 10.21315/mjms2021.28.5.10

Copyright (license): CC BY 4.0


Summary of article contents:

Introduction

Excisional haemorrhoidectomy, particularly the Milligan–Morgan technique, is recognized as the gold standard treatment for haemorrhoid disease, offering the lowest recurrence rates. Traditionally performed as an inpatient procedure, advancements such as the LigaSure™ device—designed for vessel sealing—have brought its implementation into the outpatient or daycare setting. This prospective interventional study aimed to evaluate the safety and efficacy of LigaSure™ haemorrhoidectomies performed under regional anaesthesia as a daycare procedure for patients with symptomatic third- and fourth-degree haemorrhoids.

Improvement in Patient Outcomes

One of the critical findings from the study was that LigaSure™ haemorrhoidectomy resulted in minimal blood loss and a low rate of postoperative complications. Out of 264 enrolled patients, only a small percentage (0.3% to 0.8%) experienced complications, such as urinary retention and bleeding. The median operating time was notably swift at 8 minutes, contributing to a median pain score of 3 on the visual analogue scale upon discharge. Additionally, most patients reported high satisfaction levels, with 89.8% feeling "very satisfied" and over 87% successfully returning to their daily activities within two weeks post-operation, highlighting the procedure's effectiveness in reducing recovery time and enhancing quality of life.

Conclusion

The findings of this study emphasize that LigaSure™ excisional haemorrhoidectomy, conducted with regional anaesthesia, is a safe and effective procedure appropriate for daycare surgery. The technique demonstrated swift operating times, minimal complications, and high patient satisfaction, making it a viable option, especially in developing countries like Sudan where healthcare resources may be limited. Consequently, LigaSure™ may facilitate easier and more efficient management of symptomatic haemorrhoids while contributing to cost-effective healthcare solutions.

FAQ section (important questions/answers):

What was the objective of the LigaSure™ haemorrhoidectomy study?

The study aimed to evaluate LigaSure™ haemorrhoidectomies performed under regional anaesthesia as a daycare procedure, focusing on safety, effectiveness, and complication rates.

How were patients recruited for the haemorrhoidectomy study?

Patients with third- and fourth-degree haemorrhoids from Kassala Police Hospital's outpatient clinic were recruited using convenient sampling from January 2018 to December 2019.

What were the main results of the study regarding complications?

Out of 264 patients, the study reported minimal complications: 0.3% had anal stenosis, 0.3% had minimal bleeding, and 0.8% experienced urinary retention. No cases of anal incontinence were noted.

What conclusion was drawn from the LigaSure™ haemorrhoidectomy study?

The study concluded that LigaSure™ excisional haemorrhoidectomy under regional anaesthesia is a safe, effective daycare procedure with low readmission and complication rates, especially suitable for developing countries.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Study on LigaSure™ Haemorrhoidectomy as a Daycare Procedure”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Table:
The term 'Table' refers to structured data presentations in the study, specifically showcasing demographic, perioperative, and complication data of patients undergoing LigaSure™ excisional haemorrhoidectomy. Tables are crucial for quickly conveying complex information, allowing for easy comparison and summarization of results relevant to patient outcomes and safety profiles.

2) Study (Studying):
The word 'Study' signifies a systematic investigation into LigaSure™ haemorrhoidectomies conducted between January 2018 and December 2019. It explores the efficacy, safety, and complications of this procedure under regional anaesthesia. The study design ensures robust data collection and informs healthcare practices regarding outpatient surgical interventions for hemorrhoids.

3) Pain:
In the context of this study, 'Pain' pertains to the discomfort experienced by patients following excisional haemorrhoidectomy. Assessing pain levels is essential for understanding postoperative recovery. Pain management strategies, including the use of designated analgesics, directly impact patient satisfaction and influence decisions regarding outpatient surgeries.

4) Post:
The term 'Post' denotes the period following the surgical procedure. In this study, it is associated with postoperative observations, including complications and recovery outcomes. Examining post-operative parameters is vital for evaluating the success of day surgeries like haemorrhoidectomy, ensuring patient safety, and identifying areas for improvement.

5) Bleeding:
'Bleeding' refers to one of the primary complications monitored during and post-surgery. It indicates potential surgical risks and outcomes associated with haemorrhoidectomies. The study documents instances of intraoperative and postoperative bleeding, emphasizing the importance of effective surgical techniques and methods for hemostasis to minimize complications.

6) Activity:
The keyword 'Activity' relates to the return of patients to their normal daily routines following surgery. Assessing recovery and resumption of activity levels is crucial for determining the efficacy of daycare procedures. High rates of return to activities signify successful surgeries and well-managed postoperative care, impacting patient quality of life.

7) Rules:
'Rules' in this context relates to the protocols established for the daycare surgery procedures. They guide patient selection, surgical methods, and postoperative monitoring to ensure safety and effectiveness. Following established rules is essential in minimizing complications and optimizing patient experiences during outpatient surgical interventions.

8) Blood:
The word 'Blood' in this study context is connected to monitoring blood loss during and after surgery. Keeping track of blood loss is critical for assessing procedural safety and can guide the need for further medical intervention. Minimal blood loss contributes to a rapid recovery and reduced complications.

9) Male:
The term 'Male' identifies one aspect of the demographic data collected in the study. Understanding the gender distribution helps detail patient profiles and identify trends in disease prevalence or outcomes with surgical interventions. Gender can influence clinical approaches and considerations in managing conditions like haemorrhoids.

10) Antibiotic (Antibacterial):
'Antibiotic' refers to medications, specifically metronidazole, administered prior to surgery to prevent infections. In this study, the prophylactic use of antibiotics is essential in ensuring patient safety and improving healing outcomes following surgical interventions. Antibiotic stewardship is critical in daycare surgery to mitigate complications.

11) Cancer:
While 'Cancer' is not directly related to the study’s focus, it may indicate considerations in the broader context of colorectal health and surgical interventions. Understanding coexisting conditions, like cancer, is important in surgical planning and patient management to tailor approaches and ensure comprehensive care.

12) Police:
The term 'Police' denotes the specific hospital setting where the study was conducted, the Kassala Police Hospital in Sudan. This context is essential since it highlights the healthcare setting's infrastructure and service availability, indicating the potential challenges and resources available for managing hemorrhoid treatments in local populations.

13) Indian:
'Indian' can reflect influences in surgical practices and techniques derived from broader medical literature. While not directly mentioned, recognizing diverse practices contributes to global knowledge sharing in surgical methodologies, enhancing outpatient procedures and addressing common diseases like hemorrhoids in various geographical settings.

14) Gupta:
The name 'Gupta' likely refers to one of the authors involved in the study, indicating expertise and contributing perspectives in the field of anaesthesiology or surgery. Acknowledgment of authors is crucial for establishing credibility and recognizing the collaborative efforts in conducting the research.

15) Cutan:
'Sudan' designates the geographical location of the study, implying regional healthcare challenges and practices. Understanding the context helps frame the study within local healthcare systems and reveals insights into the applicability of LigaSure™ techniques within a relevant demographic and resource setting.

16) Observation:
'Observation' refers to the careful monitoring of patient outcomes during and after the surgical procedure. In this study, observations are crucial for identifying complications, pain levels, or recovery rates post-surgery, aiding in the evaluation of the intervention's effectiveness and establishing informed healthcare practices.

17) Discussion:
The term 'Discussion' encompasses the analysis and interpretation of study findings, comparing results to existing literature. This section allows for critical evaluation of outcomes, providing insights into the implications of LigaSure™ excisional haemorrhoidectomy in outpatient settings and facilitating future research directions.

18) Developing:
'Developing' refers to nations or regions with limited healthcare resources and infrastructure. The study focuses on providing insights for effective outpatient procedures in developing countries like Sudan. Such considerations are vital for adapting surgical techniques to improve patient outcomes in resource-limited settings.

19) Disease:
'Disease' pertains specifically to haemorrhoid conditions being treated in the study. Understanding the nature of the disease informs surgical techniques and postoperative care. Addressing symptoms effectively balances the need for interventions while ensuring patients attain satisfactory recovery and quality of life post-treatment.

20) Field:
'Field' describes the medical specialty area of proctology, under which this study falls. Defining the field is essential to understand the context of surgical interventions and the expertise needed for managing conditions such as haemorrhoids, which influence treatment strategies and patient care standards.

21) Diet:
In this study, 'Diet' underscores the importance of dietary modifications in postoperative care, particularly relating to fibre intake for patients recovering from haemorrhoid surgery. Encouraging dietary changes can aid in preventing complications like constipation, promoting effective healing and overall recovery post-surgery.

22) Wall:
'Wall' likely concerns the anatomical structures involved in the procedure, specifically referring to the vessel walls treated during LigaSure™ haemorrhoidectomy. Understanding vascular anatomy is essential for effective sealing during surgery, contributing to operational success and enhancing recovery outcomes.

23) Gold (Golden):
'Gold' references the term 'gold standard,' indicating that excisional haemorrhoidectomy is considered the best approach for treating haemorrhoids with favorable outcomes. Recognizing this contributes to evaluating the effectiveness of innovative techniques like LigaSure™ against established surgical practices.

24) Drug:
'Drug' refers broadly to therapeutic agents including analgesics and antibiotics used during and after the surgical procedure. The inclusion of drugs in patient care is critical for managing pain, minimizing infection risks, and ultimately improving overall surgical outcomes and patient satisfaction.

Other Health Sciences Concepts:

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Discover the significance of concepts within the article: ‘Study on LigaSure™ Haemorrhoidectomy as a Daycare Procedure’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:

Bleeding, Daily activities, Surgical treatment, Wound healing, Conflict of interest, Developing countries, Follow Up Period, Blood loss, Visual analogue scale, Interventional study, Recurrence Rate, Institutional review board, Haemorrhoidectomy, Pain score, Urinary retention, Prospective study, Anal stenosis, Selection bias, Study period, Spinal anaesthesia, Post-operative pain, Patient satisfaction, Anal incontinence, Pain Control, Diathermy, Hospital stay, Upper GI bleed, Haemostasis, Lithotomy position, Third degree haemorrhoids, Fourth degree haemorrhoids, Treatment cost, Gold standard, Median age, Endoscopic examination, Short Term Outcomes, Internal haemorrhoid, Rapid haemostasis, Saddle Block, Operative Time, Complication rate, Daily activity, Outpatient Clinic, Study outcome, Symptomatic haemorrhoids, Post operative complication, Convenient sampling, Regional anaesthesia, Prospective design, Audio-feedback, Short-term outcome, Wound bleeding, Stool softener, Urinary catheterisation, Perioperative pain, Regional block.

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