Diathermy

About: Diathermy is a research topic. Over the lifetime, 1489 publications have been published within this topic receiving 22084 citations.

Randomized clinical trial of Ligasure versus open haemorrhoidectomy.

Abstract: Background: Postoperative pain associated with open haemorrhoidectomy remains problematic. Haemorrhoidectomy performed using bloodless bipolar diathermy – Ligasure™ – may have advantages over conventional open haemorrhoidectomy in terms of operating time and postoperative pain. Methods: Thirty-four patients were randomized to undergo Ligasure™ (18 patients) or diathermy (16) haemorrhoidectomy. The operating time, amount of pain and postoperative analgesic requirement, postoperative complications and overall patient satisfaction were documented. Results: The median duration of operation was shorter in the Ligasure™ haemorrhoidectomy group (5·1 versus 9·2 min; P < 0·001). There was no statistically significant difference in the postoperative pain score, but the median analgesic requirement was lower in the Ligasure™ group (850 versus 1600 mg tramadol; P = 0·013). Patient satisfaction was similar in both groups. Conclusion: Ligasure™ haemorrhoidectomy is quick and bloodless and, although as painful as diathermy haemorrhoidectomy, is associated with a reduced analgesic requirement. © 2002 British Journal of Surgery Society Ltd

Electrotherapy Explained: Principles and Practice

Abstract: Introduction Therapeutic direct current Electrical stimulation of nerve and muscle Evaluation and diagnosis Biofeedback Therapeutic ultrasound Heat and cold Therapeutic conduction heating Cold therapy Electromagnetic fields: shortwave diathermy, pulsed electromagnetic energy and magnetic therapies Electromagnetic radiation Microwave diathermy Infrared and visible radiations Laser therapy Ultraviolet radiation.

Stapled hemorrhoidectomy--cost and effectiveness. Randomized, controlled trial including incontinence scoring, anorectal manometry, and endoanal ultrasound assessments at up to three months.

Abstract: PURPOSE: Stapled hemorrhoidectomy is performed without leaving painful perianal wounds. The aim of this study was to assess any benefits, compared with a conventional open diathermy technique. METHODS: A total of 119 consecutive patients with prolapsed irreducible hemorrhoids were randomly assigned (conventional open diathermy technique=62; stapled hemorrhoidectomy=57). Preoperative fecal incontinence scoring, anorectal manometry, and endoanal ultrasound were performed. Postoperatively, these were repeated at up to three months with pain scores, analgesic requirements, quality of life assessment, and total related medical costs. RESULTS: Conventional open diathermy technique was quicker to perform (mean, 11.4 (standard error of the mean, 0.9)vs. 17.6 (3.1) minutes). Hospitalization was similar, but conventional open diathermy technique patients felt more pain during defecation (5.1 (0.4)vs. 2.6 (0.4);P<0.005) at two weeks, and analgesic requirements were more for up to six weeks (P<0.05). Up to the latter, 85.5 percent conventional open diathermy technique wounds remained unhealed, with more bleeding (33 (53.2 percent)vs. 19 (33.3 percent);P<0.05) and pruritus (27 (43.5 percent)vs. 9 (15.8 percent);P<0.05). Total complication rates were similar (conventional open diathermy technique 16 (25.8 percent)vs. stapled hemorrhoidectomy 10 (17.5 percent)), including mild strictures and bleeding in both groups. Minor incontinence occurred postoperatively in two conventional open diathermy technique and two stapled hemorrhoidectomy patients at six weeks. Endoanal ultrasound internal anal sphincter defects were found in the incontinent conventional open diathermy technique patients, but were asymptomatic in another one conventional open diathermy technique and one stapled hemorrhoidectomy. Only one patient (conventional open diathermy technique with internal sphincter defect) remained incontinent at three months. Changes between preoperative and postoperative anorectal manometry were similar in the two groups. Patients' satisfaction scores and quality of life assessments were also similar. Conventional open diathermy technique patients resumed work later (mean 22.9 (1.8)vs. 17.1 (1.9) days;P<0.05), but the total costs incurred were less ($921.17 (16.85)vs. $1,283.09 (31.59);P<0.005). CONCLUSIONS: Stapled hemorrhoidectomy is a safe and effective option in treating irreducible prolapsed piles. It is more expensive but less painful, with less time needed off work. Nonetheless, long-term results are still awaited.

Loop diathermy excision of the cervical transformation zone in patients with abnormal cervical smears.

Abstract: OBJECTIVE--To determine the efficacy and morbidity of fine loop diathermy excision of the cervical transformation zone as applied to the management of outpatients with abnormal cervical smears. DESIGN--Prospective programme trial with six month follow up. SETTING--Two hospital based colposcopy clinics. PATIENTS--616 Patients aged 16-60 with abnormal cervical smears. INTERVENTIONS--After colposcopic and cytological assessment excision of the cervical transformation zone by fine loop diathermy under local anaesthesia in the outpatient department. MAIN OUTCOME MEASURES--Time to complete the treatment, immediate morbidity in terms of discomfort and bleeding, and cytological and colposcopic findings at six months. RESULTS--Treatment was completed in a mean of 3.47 minutes (SD 1.99). Immediate morbidity was minimal, and histological specimens were adequate in over 90% of cases. Almost two thirds of patients were treated at their first visit to the clinic. 58 Patients (9.4%) failed to attend for follow up at six months and one had had a hysterectomy. Of the 557 patients who attended for colposcopic and cytological follow up at six months, 506 (91%) were normal cytologically and 19 (3.4%) had histologically confirmed persistence of cervical intraepithelial neoplasia. The overall confirmed failure rate of the technique was 4.4%. CONCLUSION--Loop diathermy excision is an effective treatment with low morbidity and is an appropriate modality for patients with abnormal cervical smears.