Surgical Outcomes of LigaSure Hemorrhoidectomy in the Elderly Population: A retrospective cohort study

Abstract

Background This study aims to assess the association between age and outcomes in patients undergoing hemorrhoidectomy. Methods This is a population-based cohort study. A retrospectively collected database with consecutive patients whose symptomatic prolapsed hemorrhoids managed by the LigaSure hemorrhoidectomy between Jan. 2015 and May 2017 was reviewed. Among 1238 patients, 1075 were under 65 years old (group 1), and 163 were 65 years old or older (group 2). Both groups were compared regarding baseline characteristics and surgical outcomes. Results All patients tolerated the whole course of the operation in the prone jackknife position without anesthetic-associated complications. There was no significant difference between these two groups regarding sex, hemorrhoids grade, operation time, duration of hospital stays, postoperative pain score, analgesic consumption, total postoperative complications, re-admission rate, reoperation rate and follow-up times. The multivariate logistic regression analysis that may contribute to postoperative complications revealed no significant difference for all complications between both groups. Conclusion The LigaSure hemorrhoidectomy for elderly patients is safe and effective without significant difference in short-term operative outcomes and all complication rates, compared with younger patients.

Excisional Hemorrhoidectomy Versus Dearterialization With Mucopexy for the Treatment of Grade III Hemorrhoidal Disease: The EMODART3 Multicenter Study

“…Other authors reported that age was not a risk factor for complications after hemorrhoidal surgery. 36,37 In a study by Yamamoto et al, 38 the total number of adverse events after hemorrhoidectomy was higher in the nonelderly group (21% vs 6%), but the difference was not statistically significant.…”

Comparing outcomes of laser hemorrhoidoplasty and LigaSure hemorrhoidectomy in grade II–III hemorrhoidal disease: a retrospective analysis

“…Some publications recommend pedicle saturation to reduce bleeding caused by the opening of the wound edges in LigaSure hemorrhoidectomy, as the incidence of delayed bleeding ranges from 0.9% to10%. 22,23 Over the long term, the recurrence rate of the disease is higher for minimally invasive techniques developed with technology compared to surgical hemorrhoidectomy. In our study, the recurrence rate was 9.4% for the laser-treated group and 2.5% for the LigaSure hemorrhoidectomy group, indicating that surgical treatment remains the gold standard treatment for hemorrhoidal disease.…”

“…In our study, the bleeding amount during the operation was significantly lower for the laser group (4.8 mL) compared to the LigaSure group (15.5 mL). Some publications recommend pedicle saturation to reduce bleeding caused by the opening of the wound edges in LigaSure hemorrhoidectomy, as the incidence of delayed bleeding ranges from 0.9% to10% 22,23 …”