Delayed Bleeding Following LigaSure Hemorrhoidectomy

Background Hemorrhoidectomy is one of the most common procedures performed in anorectal surgery. Regardless of the method of surgical ablation of hemorrhoids it carries the risk of troublesome complications. Postoperative pain, urinary retention, infection, anal stenosis and bleeding are the most common. Delayed postoperative bleeding after hemorrhoidectomy has a reported incidence of 0.9 10%. The purpose of this study was to assess the impact of suture ligation of the hemorrhoidal pedicle following Ligasure hemorrhoidectomy on the incidence of delayed postoperative hemorrhage. Methods Retrospective review of 180 patients who had Ligasure Hemorrhoidectomy for third and fourth degree hemorrhoids was conducted. Control group (n=90) had the original sutureless Ligasure Hemorrhoidectomy. In the study group (n=90) a modification of our original technique was applied a hemostatic suture of the hemorrhoidal pedicle was added. Independent t-test was used to determine whether there was a difference in the incidence of postoperative bleeding between the groups. Results There were 90 patients in the study group (Ligasure Hemorrhoidectomy with suture ligation of the hemorrhoidal pedicle) and 90 patients in the control group (without suture ligation). There was no statistically significant difference in the incidence of delayed postoperative hemorrhage between the groups (3.3% vs. 6.7%, p>0.33). Conclusions Ligasure Hemorrhoidectomy with suture ligation of the hemorrhoidal stalk is not superior to Ligasure Hemorrhoidectomy alone in respect of preventing delayed postoperative hemorrhage. Nevertheless, there was a trend in the study group towards decreased incidence of bleeding and need for revisional surgery. Larger study seems justified.