Randomized clinical trial of LigaSure™ and conventional diathermy haemorrhoidectomy

Background: The aim of this randomized prospective trial was to compare LigaSure (TM) and conventional diathermy haemorrhoidectomy. Methods: Two hundred and eighty-four patients with grade III or IV haemorrhoids were randomized to LigaSure (TM) or diathermy (Milligan-Morgan) haemorrhoidectomy as a day-case procedure. Operating time, postoperative pain score, hospital stay, postoperative complications, wound healing time and time to return to normal activities were assessed. Thirty-four patients were lost to follow-up. Results: The mean operating time for LigaSure (TM) haemorrhoidectomy was significantly shorter than that for diathermy (P = 0.011). Patients treated with LigaSure (TM) had significantly less postoperative pain (measured on a visual analogue scale; P = 0.010), a shorter wound healing time (defined as time to absence of swelling; P = 0.012) and less time off work (P = 0.010) than patients who had diathermy. Neither postoperative complications nor mean hospital stay (day-case surgery) were significantly different. Conclusion: LigaSure (TM) haemorrhoidectomy demonstrates simplicity, reproducibility, a low complication rate, fast wound healing, a quick return to work and reduced postoperative pain.