2012

Long-term results and quality of life in patients treated with hemorrhoidectomy using two different techniques: Ligasure versus transanal hemorrhoidal dearterialization


Zampieri N., Castellani R., Andreoli R., Geccherie A.
Am J Surg. 2012 Nov;204(5):684-8

BACKGROUND:
Hemorrhoids are the most frequent anal pathology. We evaluated the results of 2 techniques at 1 year after surgery.

METHODS:
The clinical charts and data of patients who underwent hemorrhoidectomy between January 2008 and June 2010 were considered and analyzed. Patients underwent surgery with 2 techniques: transanal hemorrhoidal dearterialization (THD) hemorrhoidectomy or LigaSure-vessel sealing system (Valleylab, Boulder, CO). Patients were chosen randomly to receive one technique or the other. The primary objectives were quality of life, quality of defecation, and regression of symptoms.

RESULTS:
Forty-six patients treated with THD and 68 patients treated with Ligasure were enrolled in the study. No significant differences were observed in the rate of postoperative surgical complications or readmissions. Shortand medium-term (1-6 mo) results showed that THD patients had a higher rate of pain resolution compared with Ligasure patients (P < .05). Functionally, all patients treated with Ligasure showed more postoperative constipation despite administration of laxatives than patients treated with THD.

CONCLUSIONS:
THD is an effective technique and is associated with the best short-term clinical and surgical outcomes if compared with Ligasure.

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