Randomized Controlled Trial Comparing the Effects of Vessel Sealing Device and Milligan Morgan Technique on Postoperative Pain Perception after Hemorrhoidectomy.

BACKGROUND: The aim of this study was to compare postoperative pain perception after Milligan Morgan and Ligasure™ techniques in hemorrhoidectomy. METHODS: Fifty-four patients diagnosed with Grade 3-4 hemorrhoids requiring surgery between May 2013 and September 2013 were enrolled in the study. Patients were randomized into either the Ligasure™ hemorrhoidectomy group (Group 1, n = 26) or the Milligan Morgan hemorrhoidectomy group (Group 2, n = 28). RESULTS: The difference between visual analogue scale scores on postoperative day 1 was not statistically significant but on the third postoperative day, the Ligasure™ group had higher visual analogue scale scores (4 ± 2.61) when compared to the Milligan Morgan hemorrhoidectomy group (2.43 ± 1.20). This difference on the third postoperative day visual analogue scale scores was statistically significant (p < 0.025). CONCLUSIONS: Ligasure™ does not seem to have an advantage in postoperative pain when compared to Milligan Morgan hemorrhoidectomy.

Spontaneous Rectus Sheath Hematoma: an Overview of 4-Year Single Center Experience.

Rectus sheath hematoma is a clinical entity characterized by the presence of blood within rectus abdominis muscle sheath. The aim of this study was to analyze clinical characteristics, diagnostic approach, treatment strategy, and outcomes of patients with rectus sheath hematoma. Patients diagnosed and treated for spontaneous rectus sheath hematoma between March 2010 and March 2014 were included in the study. A total of 10 patients were diagnosed as spontaneous rectus sheath hematoma. The mean age was 66.5 ± 16.9 years, and the mean hospital stay was 4.4 ± 1.8 days. There was no mortality. Six patients were using anticoagulant or antiplatelet agents. Eight patients recovered after conservative treatment. Two patients underwent surgery. Spontaneous rectus sheath hematoma is associated with anticoagulant therapy. Cases with abdominal pain and a non-pulsatile abdominal mass particularly in elderly women should be kept in mind. Treatment is mostly based on supportive care to preserve hemodynamic stability.