LigaSure hemorrhoidectomy compared with stapled hemorrhoidopexy for management of grade III and IV hemorrhoids: A prospective randomized study.

摘要

Conventional hemorrhoidectomy often associated with post-operative complications, like pain, bleeding, anal stenosis, and incontinence, which can cause delayed convalescence. The Ligasure Vessel Sealing System (LVSS) enables us to do a bloodless hemorrhoidectomy with decreased pain postoperatively and rapid healing. Pain suspected to be low in stapled hemorrhoidopexy as the staple line is positioned above the dentate line and there is no external wound. Objective: To compare the efficacy and outcome of two surgical methods LigaSure versus stapler in the treatment of hemorrhoids. Patients & Methods: A prospective randomized study was done in the General Surgery department, Zagazig University hospital during the period from May 2016 till October 2017. Patients underwent surgical excision of hemorrhoids grade III or grade IV. They were divided into two groups: group (A) managed by Ligasure hemorrhoidectomy and group (B) managed by Stapled hemorrhoidopexy. Postoperative complications and Pain levels scoring were analyzed. Results: Group (A) had less operative time and recurrent prolapse while postoperative pain in Group (B) was statistically significantly lower with less analgesic requirement. As regarding other postoperative complications. The difference was not statistically significant between both groups. Conclusion: This study demonstratedthat Ligasure hemorrhoidectomy and stapled hemorrhoidopexy have good results, with a short operative time and few side effects in the treatment of hemorrhoids grade III and IV. Stapled hemorrhoidopexy offers much less pain but more recurrent prolapsed. Also we recommend a larger controlled study to prove recurrence of postoperative hemorrhoidalprolapse after treatment of hemorrhoids grade III and IV by LigaSure or stapler.