LigaSure hemorrhoidectomy versus excisional diathermy hemorrhoidectomy for all symptomatic hemorrhoids

Abstract

Background: Hemorrhoidectomy by LigaSure electrosurgical unit seems to be very effective treatment and results in better surgical outcomes when compared with the conventional excisional hemorrhoidectomy. Objective: The aim of this study was to compare the feasibility and the surgical outcomes of LigaSure hemorrhoidectomy with that of conventional diathermy excisional hemorrhoidectomy. Materials and Methods: Patients characteristics were comparable in both groups. Ninety six patients with symptomatic mainly grade III and IV piles were randomized for either conventional excisional hemorrhoidectomy (48 patients) or to LigaSure hemorrhoidectomy (48 patients) for the period from April 2014 to July 2016. The surgical outcomes of both procedures including the operative time, intra-operative blood loss, postoperative pain, analgesic requirements, early and late postoperative complications, wound healing, recovery time and return to work, recurrence and patient satisfaction were recorded, compared and evaluated. Results: The mean operative time and amount of intra-operative blood loss were significantly lower in LigaSure hemorrhoidectomy group. Postoperative pain and need for parentral analgesia were comparable in the first 24 -48 hours postoperatively, but they were significantly lower in LigaSure group after the second postoperative day. Faster wound healing and early return to work were obviously noted among patient subjected to LigaSure hemorrhoidectomy. Early postoperative complications were lower in LigaSure group while late complications were comparable in both groups. Lastly, LigaSure group showed high satisfaction rate compared to conventional hexcisional hemorrhoidectomy group. Conclusion: LigaSure hemorrhoidectomy is superior and more advantageous in term of operative time, blood loss, post-operative complications, faster wound healing and return to work. It is simple, feasible and easy to learn.