Randomised trial comparing LigaSure haemorrhoidectomy with the diathermy dissection operation

Abstract

The study was designed to compare LigaSure haemorrhoidectomy with open haemorrhoidectomy performed by means of diathermy excision. Fifty-sixty consecutive patients with third- and fourth-degree haemorrhoids were randomly allocated to undergo either LigaSure haemorrhoidectomy (29 patients) or diathermy haemorrhoidectomy (27 patients). All patients were evaluated for operative time, pain, post-operative analgesic requirements, time to first bowel movement, length of hospital stay, wound healing period, time to return to work, and occurrence of early postoperative complications (such as urinary dysfunction, bleeding, soiling, seepage, continence disorders) and late complications (such as stenosis). A statistically significant advantage was observed in the patients who received the LigaSure technique as far as concerns length of operative time (9.2 vs. 12.2 min, p<0.001), post-operative analgesic requirements (14.1 vs. 16.8 administrations, p<0.001), wound healing period (16.3 vs. 37.5 days, p< 0.0001), and time to return to work (8.3 vs. 18.3 days, p<0.01). No significant difference was seen in the postoperative pain score, complications rate, first bowel motion or hospital stay. No recurrence was observed at the 6-month follow-up. In conclusion, our experience shows that the LigaSure haemorrhoidectomy offers definite advantages over the classic diathermy technique. This procedure is easier, safer, and more rapid to perform and is followed by a faster wound healing time, a significantly shorter hospital stay, less postoperative pain and faster wound healing.

A comparative study of modern techniques of stapled versus enseal haemorrhoidectomy: a prospective randomized trial on 240 cases

“…1,3,4,6,[8][9][10][11][12][13][14][15][16][17][18] Anal/rectal stenosis observed was about five times higher in EH group in spite of leaving islands of normal skin and mucosa to avoid stricture formation, which was managed conservatively. Recurrence, residual skin tags and prolapse were observed to be three times higher in SH group, comparable results were observed by Yang J et al [1][2][3][4][5] …”

Meta-analysis of Short-term Outcomes of Randomized Controlled Trials of LigaSure vs Conventional Hemorrhoidectomy

“…Seven studies [22][23][24][25][26]29,30 reported data regarding pain on postoperative day 1, measured by the Visual Analogue Scale (VAS). A score of 0 represents no pain, while a score of 10 represents the worst pain.…”

“…24,28 All patients in both the LigaSure and conventional hemorrhoidectomy arms of the analysis had a mixture of internal and external hemorrhoidal components treated at the time of operation. The sensitivity analysis included 9 studies that scored 4 or more stars on the modified Jadad Scale, 22,24-28 5 studies that compared LigaSure with open hemorrhoidectomy, 22,[25][26][27]29 4 that compared LigaSure with closed hemorrhoidectomy, 23,24,28,30 7 that compared LigaSure with diathermy hemorrhoidectomy, [23][24][25][26][27]29,30 and 2 that compared LigaSure with scissors hemorrhoidectomy. 22,28 Results of operative and postoperative parameters and complications for LigaSure hemorrhoidectomy vs conventional hemorrhoidectomy groups are summarized in Table 2.…”

Perioperative outcomes using LigaSure™ compared to conventional bipolar instruments in laparoscopic salpingo-oophorectomy: a randomized controlled trial

“…However, we were not able to confirm these favorable results as reported in previous published studies [5,8,[15][16][17][18][19][20][21][22][23][24]. Most of these laparoscopic studies involved bowel surgery and compared LigaSure with ultrasonic devices [8,16,19,20].…”