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HemorrhoidsLDHLANCT00617448

Ligasure Versus Diathermy Haemorrhoidectomy Under Local Anesthesia

A study testing diathermy haemorrhoidectomy under espinal anesthesia, diathermy haemorrhoidectomy under local anesthesia and Ligasure haemorrhoidetomy under spinal anestesia in people with Hemorrhoids, run by Hospital de Viladecans at 1 site in Spain.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The objective of this prospective randomised trial was to compare the short- and long-term efficacy of conventional diathermy haemorrhoidectomy versus Ligasure™ diathermy, and to assess the short-term outcome of each procedure performed either under spinal anaesthesia or local anaesthesia with pudendal block with… Read more about this study

Who is it for?
Ages 20 to 90 years
Conditions the study is for
Hemorrhoids
What is being tested?
diathermy haemorrhoidectomy under espinal anesthesia, diathermy haemorrhoidectomy under local anesthesia and Ligasure haemorrhoidetomy under spinal anestesia
Could I receive a placebo?
No, everyone receives an active treatment
How many people
81 participants
Where
1 siteSpain
Study dates
May 2005to Jun 2007
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 20 to 90 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • patients with a long-standing history of symptomatic grade III or IV haemorrhoids

Who cannot join

  • previous anal surgery, concomitant anal disease (fissure, fistula, incontinence and inflammatory bowel disease), use of anticoagulants or analgesics, known hypersensitivity to local anaesthetics and the inability to give written informed consent.

Trial locations and contacts

1 site in 1 country.

Spain1 site
  • Hospital de Viladecans (Departement of surgery: coloproctology)

    Viladecans, Barcelona, 08840

Other trials in Spain

About this study

Official title: Ligasure™ Versus Diathermy Haemorrhoidectomy Under Spinal or Local Anaesthesia With Ropivacaine. A Randomized Study With One Year Follow-up

The objective of this prospective randomised trial was to compare the short- and long-term efficacy of conventional diathermy haemorrhoidectomy versus Ligasure™ diathermy, and to assess the short-term outcome of each procedure performed either under spinal anaesthesia or local anaesthesia with pudendal block with ropivacaine combined with intravenous sedation.

We think, Ligasure haemorrhoidectomy under local anesthesia can be performed as day-case procedure and with equal results at long-term than conventional diathermy (considered goal standar of haemorrhoidectomy).

Read the detailed description

Seventy-four consecutive patients with a long-standing history of symptomatic grade III or IV haemorrhoids were assigned randomly by means of a computer-generated list to conventional diathermy haemorrhoidectomy under spinal anaesthesia (group I); conventional diathermy haemorrhoidectomy with local anaesthesia combined with intravenous sedation (group II); Ligasure™ under spinal anaesthesia (group III) and Ligasure™ with local anaesthesia combined with intravenous sedation (group IV). Allocations were sealed in opaque numbered envelopes. All patients were operated on electively and by the same surgical team (two colorectal surgeons) and variables were collected after operation by an independent observer who was unaware of the operation performed.

The intraoperative time was measured. Intraoperative and early (within the first 48 h) postoperative complications associated with the surgical procedure and complications related to the anaesthetic technique (headache, vomiting, nausea, acute urinary retention, bleeding and hypotension) were recorded. A 100-mm visual analogue scale (VAS) was used to assess the intensity of pain, which was measured at 2, 6 and 24 hours postoperatively and during the first bowel movement. Seven days after surgery, patients were contacted by phone and the following data were recorded: VAS score at rest and during bowel movements, bleeding (categorised as 0 = none, 1 = occasional with defecation, 2 = with each defecation, 3 = with and without defecation) and pruritus (categorised as 0 = none, 1 = occasional, 2 = frequent) and tenesmus (categorised as 0 = none, 1 = occasional, 2 = frequent). These variables were collected at 4 and 12 months after operation by an independent observer who was unaware of the operation performed. Clinical evaluation at 1 year included relapse, continence according to the incontinence score system of Jorge and Wexner19, anal stenosis, presence of skin tags, patient's degree of satisfaction (where 0 corresponded to a unsatisfactory result and 10 an excellent result) and days of sick leave.

Conditions
Hemorrhoids
Being tested
diathermy haemorrhoidectomy under espinal anesthesia, diathermy haemorrhoidectomy under local anesthesia, Ligasure haemorrhoidetomy under spinal anestesia, Ligasure haemorrhoidectomy under local anesthesia
Keywords
diathermy hemorrhoids, Ligasure, randomized controlled trial, Postoperative pain, Surgical Procedure, Ambulatory, Local Anesthesia, Safety procedure long term, Day Surgery
Medical subject headings
Hemorrhoids, Pain, Postoperative

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • diathermy haemorrhoidectomy under espinal anesthesiaProcedure or surgery

    Also called diathermy excision haemorrhoids regional, open haemorrhoidectomy, regional anesthesia

    For surgery: conventional haemorrhoidectomy with diathermy (Milligan-Morgan).For anesthesia: lidocaine 2% at doses of 50-70 mg was used for spinal anaesthesia.

  • diathermy haemorrhoidectomy under local anesthesiaProcedure or surgery

    Also called diathermy excision haemorrhoids regional, open haemorrhoidectomy, perianal anesthetics infiltration, pudendal block

    For surgery: conventional haemorrhoidectomy with diathermy (Milligan-Morgan). For anesthesia: pudendal nerve block, infiltration of the right and left pararectal spaces, anterior and presacral regions with ropivacaine (150 mg of ropivacaine [20 mL, 7.5 mg/mL] diluted in 50 mL of 0.9% physiological saline). Ten minutes before local anaesthesia, patients were sedated with i.v. remifentanil 0.05-0.15 μg·kg-1

  • Ligasure haemorrhoidetomy under spinal anestesiaProcedure or surgery

    Also called regional anesthesia, Ligasure for prolapsed piles

    For surgery: ligasure haemorrhoidectomy For anesthesia: lidocaine 2% at doses of 50-70 mg was used for spinal anaesthesia.

  • Ligasure haemorrhoidectomy under local anesthesiaProcedure or surgery

    Also called Ligasure for prolapsed piles, Pudendal block

    For surgery: haemorrhoidectomy with Ligasure For anesthesia: pudendal nerve block, infiltration of the right and left pararectal spaces, anterior and presacral regions with ropivacaine (150 mg of ropivacaine [20 mL, 7.5 mg/mL] diluted in 50 mL of 0.9% physiological saline). Ten minutes before local anaesthesia, patients were sedated with i.v. remifentanil 0.05-0.15 μg·kg-1

Study groups in NCT00617448
Study groupRoleWhat they receive
IActive comparatorconventional diathermy haemorrhoidectomy under spinal anaesthesia
Receives: Procedure: diathermy haemorrhoidectomy under espinal anesthesia
IIActive comparatorconventional diathermy haemorrhoidectomy with local anaesthesia combined with intravenous sedation (group II)
Receives: Procedure: diathermy haemorrhoidectomy under local anesthesia
IIIActive comparatorLigasure haemorrhoidectomy under spinal anesthesia
Receives: Procedure: Ligasure haemorrhoidetomy under spinal anestesia
IVActive comparatorLigasure haemorrhoidectomy under local anesthesia
Receives: Procedure: Ligasure haemorrhoidectomy under local anesthesia

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. all cause morbility within the first 7 days after surgery (consequence of surgery and anesthesia) and results sintomatology since 12 months

    Measured: at 2, 6, 24 horus, 7 days, 4 and 12 monts after surgery

Secondary outcomes (1)
  1. intraoperative time, postoperative complications, pain (VAS), bleeding, pruritus and tenemus, continence ( score system of Jorge and Wexner), anal stenosis, presence of skin tags, degree of satisfaction and days of sick leave.

    Measured: Intraoperative, at 2,6,24 hours and 7 days after surgery and 4 and 12 monts after surgery

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Feb 2008 (estimated)
  2. Study startMay 2005
  3. Primary completionJun 2006
  4. Study completionJun 2007

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
81 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00617448
Sponsor's protocol ID
05/0008
Acronym
LDHLA
Status last verified
Feb 2008
First submitted
5 Feb 2008
Last updated
18 Feb 2008
Results posted
No
Data monitoring committee
Yes

Publications

  • Jayne DG, Botterill I, Ambrose NS, Brennan TG, Guillou PJ, O'Riordain DS. Randomized clinical trial of Ligasure versus conventional diathermy for day-case haemorrhoidectomy. Br J Surg. 2002 Apr;89(4):428-32. doi: 10.1046/j.0007-1323.2002.02056.x.

    PubMed 11952582
  • Palazzo FF, Francis DL, Clifton MA. Randomized clinical trial of Ligasure versus open haemorrhoidectomy. Br J Surg. 2002 Feb;89(2):154-7. doi: 10.1046/j.0007-1323.2001.01993.x.

    PubMed 11856126
  • Peters CJ, Botterill I, Ambrose NS, Hick D, Casey J, Jayne DG. Ligasure trademark vs conventional diathermy haemorrhoidectomy: long-term follow-up of a randomised clinical trial. Colorectal Dis. 2005 Jul;7(4):350-3. doi: 10.1111/j.1463-1318.2005.00817.x.

    PubMed 15932557
  • Basdanis G, Papadopoulos VN, Michalopoulos A, Apostolidis S, Harlaftis N. Randomized clinical trial of stapled hemorrhoidectomy vs open with Ligasure for prolapsed piles. Surg Endosc. 2005 Feb;19(2):235-9. doi: 10.1007/s00464-004-9098-0. Epub 2004 Dec 2.

    PubMed 15573239
  • Masoni L, La Torre F, Otti M, Pascarella G, Gasparrini M, Riso V, Cottini F, Montori A. [Hemorrhoidectomy with ropivacaine (Naropin) local anesthesia. Preliminary experience]. Minerva Chir. 2000 May;55(5):383-7. Italian.

    PubMed 10953578
  • Lohsiriwat D, Lohsiriwat V. Outpatient hemorrhoidectomy under perianal anesthetics infiltration. J Med Assoc Thai. 2005 Dec;88(12):1821-4.

    PubMed 16518980
  • Vinson-Bonnet B, Coltat JC, Fingerhut A, Bonnet F. Local infiltration with ropivacaine improves immediate postoperative pain control after hemorrhoidal surgery. Dis Colon Rectum. 2002 Jan;45(1):104-8. doi: 10.1007/s10350-004-6121-4.

    PubMed 11786772
  • Kim J, Lee DS, Jang SM, Shim MC, Jee DL. The effect of pudendal block on voiding after hemorrhoidectomy. Dis Colon Rectum. 2005 Mar;48(3):518-23. doi: 10.1007/s10350-004-0798-2.

    PubMed 15875295
  • Haveran LA, Sturrock PR, Sun MY, McDade J, Singla S, Paterson CA, Counihan TC. Simple harmonic scalpel hemorrhoidectomy utilizing local anesthesia combined with intravenous sedation: a safe and rapid alternative to conventional hemorrhoidectomy. Int J Colorectal Dis. 2007 Jul;22(7):801-6. doi: 10.1007/s00384-006-0242-2. Epub 2006 Nov 22.

    PubMed 17119982

Questions about this trial

What is this clinical trial studying?

A study testing diathermy haemorrhoidectomy under espinal anesthesia, diathermy haemorrhoidectomy under local anesthesia and Ligasure haemorrhoidetomy under spinal anestesia in people with Hemorrhoids, run by Hospital de Viladecans at 1 site in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 18 Feb 2008. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

all cause morbility within the first 7 days after surgery (consequence of surgery and anesthesia) and results sintomatology since 12 months (time frame: at 2, 6, 24 horus, 7 days, 4 and 12 monts after surgery). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00617448, which also lists 9 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Feb 2008.

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