Ligasure hemorrhoidectomy versus Stapled hemorrhoidopexy: a prospective randomized clinical trial

The aim of this study was to compare the outcome of Ligasure hemorrhoidectomy (LH) and Stapled hemorrhoidopexy (SH) for prolapsed hemorrhoids.

Sixty-eight patients with grades III and IV hemorrhoids were randomized into two groups of 34 each, to undergo LH (Group 1) or SH (Group 2). Patient demographics, operative details, postoperative pain score, number of parenteral analgesic injections, hospital stay, and time to return to work were all prospectively collected. Postoperative complications and recurrence of prolapse were also recorded. All patients were regularly followed-up for a total period of 18 months.

Patient demographics and clinical characteristics were similar between both groups. The mean operating time, postoperative pain score, parenteral analgesics, hospital stay and time off work were not statistically significant between both groups. Likewise, both groups had similar postoperative complications except for a residual prolapse that was observed, at four weeks postoperatively, in eight patients (23.53%) in the SH group as compared to two patients (5.89%) in the LH group (P=0.040). Although hemorrhoid recurrence, at 18 months, was also higher among the SH group as compared to the LH group (11.76% vs. 2.94%, respectively), yet the difference was not statistically significant (P=0.163).

Both LH and SH yield comparable good results and minimal side effects for the treatment of grades III and IV hemorrhoids, with less residual prolapses observed with LH. Further, owing to their low postoperative pain, short hospital stay and rapid return to work, both procedures offer an excellent therapeutic option for prolapsed grades III and IV hemorrhoids.