Does the use of ligasure improve the outcome of hemorrhoidectomy?

Background: Several surgical modalities were advocated to improve the results of hemorrhoidectomy. Ligasureis one of the recent techniques to optimize the outcome of hemorrhoidectomy. But until now, conventional Milligan and Morgan diathermy hemorrhoidectomy is still the standard operation. Our aimin this study is to answer the question, does the use of Ligasure improve the outcome of hemorrhoidectomy in comparison with the conventional hemorrhoidectomy?. Patients and Methods: This was a prospective comparative multicenter study. The study populations consisted of patients attended to the surgical outpatient clinic in Sohag University Hospitals and Qena University Hospitals between October 2013 and April 2017. The patients were classified into two groups, the first group had conventional hemorrhoidectomy and the second group had Ligasure hemorrhoidectomy. Demographic data and surgical outcome were compared in both groups. Results: 185 patients had fulfilled our inclusion criteria and were included in this study. 93 patients had conventional hemorrhoidectomy (CH) and 92 had Ligasure hemorrhoidectomy (LH). The mean age of both groups were41.55±10.36 and 39.50±8.59 years respectively without significant P value (P= 0.183). The mean operative time for CH was (30.34±8.51 minutes) and for LH (18.43±5.51 minutes) which was statistically significant (P=0.027). The intraoperative blood loss and postoperative pain were significantly lower in LH(P=0.001). Hospital stay was significantly shorter (P=0.001) among ligasure group. Also, the return to work was earlier in LH(P=0.001). Conclusion: Ligasure hemorrhoidectomy had many advantages over conventional hemorrhoidectomy such as reduction of operative time, less intraoperative blood loss, less postoperative pain, shorter hospital stay and early return to work. So it is safe substitute to conventional technique and should be used when available.