Ligasure Hemorrhoidectomy: Updates on Complications After an 18-Year Experience

Abstract

Background: Hemorrhoidal disease represents one of the most common anorectal disorders in the general population. Energy devices, such as LigaSureTM scalpel, have reshaped the concept of hemorrhoid surgery and in turn, have improved patient outcomes and simplified the work of surgeon. Objective: The study aims to evaluate the outcomes of LigaSureTM hemorrhoidectomy (LH) analyzing main post-operative complications rate, length of stay, operating time and time to return to work. Methods: In this monocentric descriptive study, from June 2001 to February 2019, 1454 consecutive patients, treated with LH for grade III and IV haemorrhoids, were analyzed. Complications were classified in early, late and long-term if they occurred within 1 month, between 1 and 2 months or after 2 months, respectively. Results: (90.2%) of patients were treated in day surgery regimen and mean operating time was 14.3 minutes. The post-operative pain decreased from 3.7 mean VAS on the 1st post-operative day to 0.1 mean VAS on 30th post-operative day. Early complications rate was 2.1%: urinary retention accounted for 1.8% of patients. 0.3% of patients experienced post-operative bleeding and only one required reoperation. Late complications rate was 5.8%: anal stenosis, incomplete healing and anal fissure were detected in 3.6%, 1.2% and 1% of patients, respectively. The Long term complications rate was 5.3 % : anal fistula, soiling, perianal abscess and recurrence were identified in 0.2%, 0.1%, 0.3% and 4.8% of patients, respectively. Conclusion: LH is a safe and fast procedure with a proven minimal complications rate.

Ambulatory Surgery for Perianal Disease

“…Haemorrhoids are arteriovenous sinusoids, located in the sub-epithelial space, embedded in connective tissue and smooth muscle fibres, participating to 15-20% of the anal continence [9][10][11][12]. Haemorrhoidal disease (HD) is characterised by abnormally congested and downward displaced haemorrhoids [11][12][13].…”

Surgical Treatment of Iatrogenic Complex Recurrent Extrasphincter Anorectal Fistula: A Clinical Case

“…После геморроидэктомии с использованием Ligasure свищи прямой кишки встречались лишь в 1% случаев через 1-2 месяца и в 0,2% более чем через 2 месяца. [13] В исследовании Klang et al изучались КТ-снимки пациентов после геморроидэктомии в срок менее чем 30 дней с момента операции: из 12 пациентов только у одного был выявлен свищ прямой кишки [14]. Таким образом, формирование свищей прямой кишки после хирургического лечения геморроя встречается только как единичные случаи и достоверно не связано с тем или иным видом вмешательства.…”

Comparison of methods of automatic bipolar sealing and monopolar coagulation in the surgical treatment of hemorrhoids in patients with diabetes

“…Narcotic analgesics in the postoperative period were used in 17 (53.1 %) patients in the control group and were not used in the study group. The timerequired for return to the normal daily activity was 6 (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)…”

“…Гемороїдальні вузли -це підслизові вузлові утворення в анальному каналі, що містять венули, артеріоли та гладеньком'язові волокна. Гемороїдальну хворобу реєструють приблизно у 5 % загальної популяції, особливо після 40 років [1,2]. Лікування показане лише у симптоматичних випадках.…”