Haemorrhoidectomy with Ligasure vs conventional excisional techniques: meta-analysis of randomized controlled trials.
OBJECTIVE
To compare the use of LigaSure devices with conventional excisional techniques, circular stapling and use of Harmonic Scalpel in patients with symptomatic haemorrhoids and to review literature on LigaSure technology (Valleylab Inc. USA).


METHODS
A literature review was performed using the National Library of Medicine's Pubmed Database using the keywords Ligasure, haemorrhoidectomy, vessel sealing technology. Randomized trials comparing LigaSure with other techniques of excisional haemorrhoidectomy with valid end points were reviewed in the present article and included in a quantitative meta-analysis.


RESULTS
There was no significant difference in the proportion of patients cured after Ligasure haemorrhoidectomy or other excisional techniques (P > 0.05). Patients treated with LigaSure had a significantly shorter operative time (P < 0.001), postoperative pain VAS Score (P < 0.001), wound healing time and time-off from work (P < 0.001), than the patients submitted to excisional techniques. Postoperative bleeding did not significantly differ between the two groups (P = 0.056); however, the surgeons observed a reduction of intra- and postoperative bleeding using LigaSure. In comparison to the circular stapler and Harmonic Scalpel the authors found similar postoperative outcomes and a slightly favourable trend for LigaSure regarding postoperative complications, ease of handling and length of the procedure.


CONCLUSIONS
Our meta-analysis shows that Ligasure haemorrhoidectomy is a fast procedure characterized by limited postoperative pain, short hospitalization, fast wound healing and convalescence.
Milito
G
G
Department of Surgery, University Hospital Tor Vergata, Rome, Italy. giovanni.milito@virgilio.it
Cadeddu
F
F
Muzi
M G
MG
Nigro
C
C
Farinon
A M
AM
D004564:Electrocoagulation / Q000009:adverse effects / Q000379:methods*; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D010149:Postoperative Pain / Q000209:etiology; D019106:Postoperative Hemorrhage / Q000209:etiology; D012008:Recurrence; D013528:Surgical Staplers; D014945:Wound Healing