Comparison of Ligasure Versus Conventional Surgery for Curative Gastric Cancer Resection: a Meta-Analysis

  • Hu, Tian-Peng (Department of Nuclear Medicine, Tianjin Medical University General Hospital) ;
  • He, Xiang-Hui (Department of General Surgery, Tianjin Medical University General Hospital) ;
  • Meng, Zhao-Wei (Department of Nuclear Medicine, Tianjin Medical University General Hospital) ;
  • Jia, Qiang (Department of Nuclear Medicine, Tianjin Medical University General Hospital) ;
  • Tan, Jian (Department of Nuclear Medicine, Tianjin Medical University General Hospital) ;
  • Li, Xue (Department of Nuclear Medicine, Tianjin Medical University General Hospital)
  • Published : 2016.06.01


Background: The LigaSure vessel sealing system has been proposed to save operation time and reduce intraoperative blood loss for various surgeries. However, its usage for gastric cancer is still controversial. The aim of the present meta-analysis was to compare the effectiveness of LigaSure with conventional surgery in gastrectomy. Materials and Methods: Sources were retrieved from the Cochrane Library, MEDLINE, EMBASE, SCOPUS and Google Scholar until February, 2015. All randomized controlled trials comparing LigaSure with conventional surgery in curative gastric cancer resection were selected. After data extraction, statistics were performed by Review Manager 5.1 software. Results: Three eligible randomized controlled trials were evaluated, with a total of 335 patients. The quality of the included trials was good, yet some methodological and clinical heterogeneity existed. There were no significant differences between the LigaSure and conventional groups in operative time (weighted mean difference [WMD], -22.95 minutes; 95% confidence interval [CI], [-59.75, 13.85]; P = 0.22), blood loss (WMD, -45.8 ml; 95% CI, [-134.5, 42.90]; P = 0.31), nor the incidence of surgical complications (odds ratio, 1.18; 95% CI, [0.68, 2.05]; P = 0.54). But there was a longer duration of hospital stay in LigaSure group (WMD, 1.41 days; 95% CI, [0.14, 2.68]; P = 0.03). Conclusions: All available randomized evidence has been summarized. LigaSure does not confer significant advantage over conventional surgery for curative gastric cancer resection. The usefulness of the device may be limited in gastrectomy. But, more trials are needed for further assessment of the LigaSure system for gastric cancer.


  1. Cipolla C, Graceffa G, Sandonato L, et al (2008). LigaSure in total thyroidectomy. Surg Today, 38, 495-8.
  2. Elhao M, Abdallah K, Serag I, et al (2009). Efficacy of using electrosurgical bipolar vessel sealing during vaginal hysterectomy in patients with different degrees of operative difficulty: a randomised controlled trial. Eur J Obstet Gynecol Reprod Biol, 147, 86-90.
  3. Eroglu A, Turkyilmaz A, Aydin Y, et al (2007). The use of the LigaSure Vessel Sealing System in esophageal cancer surgery. Ann Thorac Surg, 84, 2076-9.
  4. Fujita J, Takiguchi S, Nishikawa K, et al (2014). Randomized controlled trial of the LigaSure vessel sealing system versus conventional open gastrectomy for gastric cancer. Surg Today, 44, 1723-9.
  5. Hagen B, Eriksson N, Sundset M (2005). Randomised controlled trial of LigaSure versus conventional suture ligature for abdominal hysterectomy. BJOG, 112, 968-70.
  6. Heniford BT, Matthews BD, Sing RF, et al (2001). Initial results with an electrothermal bipolar vessel sealer. Surg Endosc, 15, 799-801.
  7. Hozo SP, Djulbegovic B, Hozo I (2005). Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol, 5, 13.
  8. Kiriakopoulos A, Dimitrios T, Dimitrios L (2004). Use of a diathermy system in thyroid surgery. Arch Surg, 139, 997-1000.
  9. Lee WJ, Chen TC, Lai IR, et al (2003). Randomized clinical trial of Ligasure versus conventional surgery for extended gastric cancer resection. Br J Surg, 90, 1493-6.
  10. Palazzo FF, Francis DL, Clifton MA (2002). Randomized clinical trial of Ligasure versus open haemorrhoidectomy. Br J Surg, 89, 154-7.
  11. Saiura A, Yamamoto J, Koga R, et al (2006). Usefulness of LigaSure for liver resection: analysis by randomized clinical trial. Am J Surg, 192, 41-5.
  12. Siegel RL, Miller KD, Jemal A (2015). Cancer statistics, 2015. CA Cancer J Clin, 65, 5-29.
  13. Silva-Filho AL, Rodrigues AM, Vale de Castro Monteiro M, et al (2009). Randomized study of bipolar vessel sealing system versus conventional suture ligature for vaginal hysterectomy. Eur J Obstet Gynecol Reprod Biol, 146, 200-3.
  14. Society JGC (2004). Guidelines for Diagnosis and treatment of carcinoma of the stomach April. 2004th ed. Tokyo: Kanehara; 2004.
  15. Song X, Meng Z, Jia Q, et al (2015). Different radioiodine dose for remnant thyroid ablation in patients with differentiated thyroid cancer: a meta-analysis. Clin Nucl Med.
  16. Songun I, Putter H, Kranenbarg EM, et al (2010). Surgical treatment of gastric cancer: 15-year follow-up results of the randomised nationwide Dutch D1D2 trial. Lancet Oncol, 11, 439-49.
  17. Spivak H, Richardson WS, Hunter JG (1998). The use of bipolar cautery, laparosonic coagulating shears, and vascular clips for hemostasis of small and medium-sized vessels. Surg Endosc, 12, 183-5.
  18. Takiguchi N, Nagata M, Soda H, et al (2010). Multicenter randomized comparison of LigaSure versus conventional surgery for gastrointestinal carcinoma. Surg Today, 40, 1050-4.
  19. Uzunoglu FG, Bockhorn M, Fink JA, et al (2013). LigaSure vs. conventional dissection techniques in pancreatic surgery--a prospective randomised single-centre trial. J Gastrointest Surg, 17, 494-500.
  20. Yao HS, Wang Q, Wang WJ, et al (2008). Intraoperative allogeneic red blood cell transfusion in ampullary cancer outcome after curative pancreatoduodenectomy: a clinical study and meta-analysis. World J Surg, 32, 2038-46.
  21. Yao HS, Wang Q, Wang WJ, et al (2009). Prospective clinical trials of thyroidectomy with LigaSure vs conventional vessel ligation: a systematic review and meta-analysis. Arch Surg, 144, 1167-74.
  22. Yao HS, Wang WJ, Wang Q, et al (2011). Randomized clinical trial of vessel sealing system (LigaSure) in esophagogastric devascularization and splenectomy in patients with portal hypertension. Am J Surg, 202, 82-90.