Randomized, prospective trial of direct current versus bipolar electrocoagulation for bleeding internal hemorrhoids
| Autor: | Russell Yang, Loren Laine, Barry Migikovsky, Jack Peicher |
|---|---|
| Rok vydání: | 1993 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Rectum Hemorrhoids Electrocoagulation Humans Medicine Blood Transfusion Radiology Nuclear Medicine and imaging Prospective Studies Treatment Failure Pain Postoperative business.industry Vascular disease Bipolar electrocoagulation Gastroenterology Bleeding internal hemorrhoids Middle Aged medicine.disease Surgery medicine.anatomical_structure Prospective trial Internal Hemorrhoid Gastrointestinal Hemorrhage business Medical therapy |
| Zdroj: | Gastrointestinal Endoscopy. 39:766-769 |
| ISSN: | 0016-5107 |
| DOI: | 10.1016/s0016-5107(93)70261-8 |
| Popis: | Fifty patients with bleeding internal hemorrhoids unresponsive to 6 weeks of standard medical therapy were randomly assigned to receive treatment with direct current or bipolar electrocoagulation. Treatment groups were similar in bleeding severity and internal hemorrhoid grade. Treatment sessions were significantly longer for direct current electrocoagulation (8.8 +/- 0.2 minutes) than for bipolar electrocoagulation (0.1 +/- 0.03 minutes) (p0.001). When compared to the bipolar electrocoagulation group, direct current electrocoagulation patients had more procedural pain that terminated therapy (5 of 25 patients [20%] versus 0 of 25 [0%], for a difference of 20% [95% confidence interval, 4% to 36%]; p = 0.05) and prolonged pain after the procedure (4 of 25 patients [16%] versus 1 of 25 [4%], for a difference of 12% [95% confidence interval, -4% to 28%]; p = 0.35). However, more post-treatment rectal ulcerations were seen in the bipolar electrocoagulation-treated group (6 of 25 patients [24%] versus 1 of 25 [4%], for a difference of 20% [95% confidence interval, 2% to 38%]; p = 0.10). Treatment groups did not differ in number of treatment sessions or months of follow-up. The rates of success, defined as obliteration of the hemorrhoids or cessation of bleeding with reduction of the hemorrhoids to grade 1 or less, for the direct current electrocoagulation and the bipolar electrocoagulation groups were 88% and 92%, respectively. Failures in the direct current electrocoagulation group were uncontrollable bleeding (n = 1) and refusal to continue therapy because of pain (n = 2).(ABSTRACT TRUNCATED AT 250 WORDS) |
| Databáze: | OpenAIRE |
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