Ligasure Versus Stapled Hemorrhoidectomy in the Treatment of Hemorrhoids

Abstract

The aim of this meta-analysis was to compare the outcomes of Ligasure hemorrhoidectomy and stapled hemorrhoidectomy for prolapsed hemorrhoids. Original studies in any language were searched from MEDLINE database, PubMed, Web of science and the Cochrane Library database, and Wangfang database. Randomized control trials that compared Ligasure hemorrhoidectomy with stapled hemorrhoidectomy were identified. Data were extracted independently for each study, and a meta-analysis was performed using fixed and random-effects models. Five trials including 397 patients met the inclusion criteria. Patients treated with Ligasure had a significantly shorter operative time compared with patients who underwent stapler techniques. The recurrence rate was higher in patients who underwent stapled hemorrhoidectomy. No statistically significant differences were observed in postoperative bleeding, urinary retention, difficult defecating, anal fissure, anal stenosis, incontinence, postoperative pain, return to normal activities, and hospital stay. Our meta-analysis shows that Ligasure is an effective instrument for hemorrhoidectomy, which results in shorter operation time and lower recurrence rate.

Evaluation and management of hemorrhoids: Italian society of colorectal surgery (SICCR) consensus statement

“…Moreover, the incidence of residual skin tags and prolapse was significantly lower in the LigaSure group than in the SH group. The data also indicated that the incidence of recurrence was significantly lower in the LigaSure group than in the SH group [62,63].…”

“…Some meta-analyses when looking at long-term outcomes after SH and conventional hemorrhoidectomy found higher recurrence rates following SH [61][62][63].…”

Consensus statement of the Italian society of colorectal surgery (SICCR): management and treatment of hemorrhoidal disease

“…Numerous studies on short-term outcomes have demonstrated that when compared to conventional hemorrhoidectomy, SH is quicker to perform and patients experience less postoperative pain, postoperative bleeding, wound complications, and constipation [96][97][98][99][100][101]. Hospital stay and time to return to normal activities were also shorter.…”

Evaluation of the LigaSure™ Vessel Sealing System for bowel transection and intestinal anastomosis—an experimental study in a porcine model

“…The LigaSure ™ Vessel Sealing System (LVSS) is commonly used for tissue preparation due to its safe and reliable coagulation of tissue resulting in reduced blood loss and has been successfully tested for hepatic, esophageal, and proctologic surgery in recent years [10][11][12][13]. Due to its properties regarding reliable tissue coagulation and sealing, the LVSS may have benefits such as a high reproducibility as well as a fast method to seal the bowel endings for creation of intestinal anastomoses compared to the thus far widely used standard methods.…”