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... Various authors have shown that bleeding per rectum was the predominant symptom. [24][25][26][27][28] However, George et al. and Thejeswi et al. have reported mass per anus followed by pain as the predominant symptom. [14,15] Post-operative pain is one of the reasons for the patients not availing surgical management in case of haemorrhoids. ...
Background: Haemorrhoids often necessitate surgical intervention. Laser haemorrhoidectomy and stapler haemorrhoidopexy are two alternative
techniques that may be employed for the resolution of symptoms. Aim: The current study aims to compare the two modalities of treatment
in terms of post‑operative pain, post‑operative complications and recurrence at 6 months. Methodology: It was a hospital‑based prospective
cohort study done in the department of general surgery at a tertiary care centre. Patients were included if they were symptomatic with Grade II
or III haemorrhoids in ano and underwent surgery in the same institute. Patients were excluded if they were <18 years of age, had co‑existing
anorectal diseases (perianal fistula, anal fissure or abscess), had a previous history of anorectal surgery or open haemorrhoidectomy, had a
history of recurrent haemorrhoids, had regular use of medications such as analgesics or immunosuppressants, had a history of neurologic
deficit or chronic pain syndrome, was unfit for surgery or anaesthesia, or if they were pregnant. Post‑operative pain was evaluated using visual
analogue scale. Results: Seventy‑two patients were included in the study, and no one was lost to follow‑up. The mean age was 51.8 (13.9)
years and ranged from 22 to 77 years. Majority were males(80.6%). Post‑operative pain was lower in the laser group at all time points. Surgical
complications were slightly lower in the stapler group. Recurrence at 6 months of follow‑up was noted in only one patient belonging to the
stapler group. Conclusion: Laser haemorrhoidectomy has significantly lower post‑operative pain, but stapler haemorrhoidopexy had lesser
post‑operative complications, though not statistically significant. Both surgical techniques have low recurrent rates.
... So the mean duration of surgery in conventional haemorrhoidectomy is significantly long. This is in comparision to a metaanalysis by Shao 10,11 . ...
... Conventional hemorrhoidectomy involves submucosal excision of hemorrhoidal plexuses and the residual wound healed by secondary intention (Miligan Morgan) or closed primarily (Ferguson) (Rakhonde et al., 2016). ...
Background: 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.
[Islam M. Ibrahim, Abd Elrahman Metwalli, Ashraf Goda. LigaSure hemorrhoidectomy compared with stapled
hemorrhoidopexy for management of grade III and IV hemorrhoids: A prospective randomized study. Life
Sci J 2018;15(4):92-99]. ISSN: 1097-8135 (Print) / ISSN: 2372-613X (Online). http://www.lifesciencesite.com. 11.
doi:10.7537/marslsj150418.11.
Keywords: Hemorrhoids, Ligasure hemorrhoidectomy, Stapled hemorrhoidopexy.
