LigasureTM Haemorrhoidectomy Versus Closed Haemorrhoidectomy in Treatment of Third and Fourth-Degree Haemorrhoids: A Prospective Comparative Study

Background: Excision haemorrhoidectomy is notoriously associated with significant postoperative pain but remains the gold standard treatment for Grade III and IV haemorrhoids because it is efficacious and affordable. The objective of this study was to compare Ligasuretarde; Haemorrhoidectomy (LH) and Closed Haemorrhoidectomy (CH). Methods: This prospective comparative study was conducted at Omdurman Teaching Hospital over two years from May 2015 to May 2017. The outcome parameters were operative time, postoperative pain, postoperative complications, time to complete healing, and time to return to work. Results: A total of 100 patients were included in the study, 50 patients in each group. The baseline characteristics were comparable between the two groups. The mean age was 40.5 ± 14.2 years, and the M:F ratio was 1.7:1. The operative time for the LH was vs. shorter than that for the CH (8.1 ± 3.1 25.5 ± 10.1 minutes, p value=0.001). The length of hospital stay was significantly shorter in the LH group (P value=0.001). The risk for rectal bleeding and urine retention in the first postoperative 48 hours was greater in the CH group than in the LH group (34% vs. 2%, P value=0.001 and 22% vs. 6%, P value=0.01, respectively). However, there was no difference in the number of patients who required rescue analgesia during the first 48 hours (74% in the CH group vs. 2% in the LH group; P value=0.01). Patients who underwent LH resumed their work earlier than those who underwent CH (P value 0.001). The surgical wound was completely epithelized in the LH earlier than in the CH (P value 0.001). Conclusion: Compared with closed haemorrhoidectomy, Ligasuretarde; haemorrhoidectomy was associated with a significantly shorter operation time, fewer postoperative complications, a shorter hospital stay, earlier return to work, and shorter postoperative healing time.