LIGASURE HAEMORRHOIDECTOMY IN COMPARISON WITH CONVENTIONAL HAEMORRHOIDECTOMY- A CASE STUDY ON 100 PATIENTS

BACKGROUND For the grade III and IV internal haemorrhoids surgery is the only treatment option and the conventional haemorrhoidectomy in them is an unvaried approach associated with significant morbidity and a prolonged recuperation, but it is a very popular method of treatment modality due to its cost effectiveness and significant long-term outcome. The Ligasure tissue sealing device is an alternative technique used in haemorrhoidectomy that has shown to produce favourable results. The objective of the study was to compare the effectiveness of the Ligasure tissue sealing device in comparison with conventional haemorrhoidectomy. MATERIALS AND METHODS 100 consecutive patients of third and fourth degree internal haemorrhoids were grouped into either the Ligasure haemorrhoidectomy (50 patients) or conventional haemorrhoidectomy (50 patients) who visited Pacific Medical College and Hospital Surgery Department for the period from January 2014 to December 2016. They were evaluated on the criteria of below mentioned main outcomes: Bleeding, post-operative pain (measured on a visual analogue scale), mean operative time, hospital stay, early and late complications, rate of wound healing and recovery time of work. Patients were followed up for 12 months (range 12 - 24). The sample size required was taken for convenience. RESULTS Hundred patients grouped into two prospective, randomised, controlled trial of fifty each for Ligasure and conventional haemorrhoid surgery. The result was compared amongst the two groups and tabulated. In comparison to conventional haemorrhoidectomy, Ligasure haemorrhoidectomy had an edge over with shorter operating time, less intraoperative and postoperative blood loss, less pain and postoperative complications including urinary retention, haemorrhage and wound breakdown. CONCLUSION Ligasure haemorrhoidectomy has proved to be superior to conventional diathermy haemorrhoidectomy. Ligasure is an effective tool when a large tissue clearance is required. With Ligasure we achieve good haemostasis, causing a wafer-thin seal of the tissue and blood vessels, sutureless surgery and the external components of haemorrhoids can also be treated together. This study concludes its use as the treatment of preference for grade III and IV haemorrhoids as a day-care procedure, even if the procedure is costlier than the conventional haemorrhoidectomy.