ligasure system versus conventional suturing for dorsal venous complex management in retropubic radical prostatectomy, operative and clinical outcomes

Introduction: the purpose of this research is to evaluate the utility and efficacy of the ligasure system compared to conventional suturing in the management of dvc in rp. method: the study involved two groups: group one, consisting of 92 patients who underwent conventional suturing for managing their dvcs (cs-dvc), and group two, consisting of 90 patients who received the ligasure system (sl-dvc). patient records were collected retrospectively, including age, preoperative hemoglobin (hb) level, smoking status, and history of opium consumption. the analyzed operative outcomes included total surgical length, postoperative hb (24 hours after surgery), and the quantity of packed red blood cells administered during and after the procedure (24 hours). tumor characteristics analyzed included tumor grade, pathologic gleason score, pathological stage, and margin status.results: men who underwent sl-dvc were older than cs-dvc group (67.52±8.29 years and 64.85±7.54 years, respectively). the cs-dvc group experienced longer operative times than sl-dvc patients (3.91±0.76 hours and 3.24±0.8 hours, respectively; p-value<0.001). preoperative and postoperative hb levels were significantly higher in the sl-dvc group compared to the cs-dvc group (p-value<0.001). however, there was no significant difference in the decrease in hb levels between two groups (p-value=0.727). no significant differences were reported in tumor grade, pathological t-stage, pathological glisson score, and margin positivity between two groups (all p-value>0.05). continence was better in the sl-dvc group (p-value=0.013), but there were no significant differences in psa recurrence and urethral stricture between two groups. conclusion: the use of either a conventional suture or a ligasure system to control the dvc in rp did not result in differences in the decrease of hb, positive margin rate, psa recurrence, and urethral stricture. however, the duration of surgery and the incontinence rate were improved in the ligasure system group. therefore, using ligasure may be a useful alternative method for dvc management.