Reviewer’s report
Title: 
Surgical Outcomes of LigaSure Hemorrhoidectomy in the Elderly
Population: A retrospective cohort study
Version: 
0 
Date: 
11 Mar 2021
Reviewer's report:
Please include all comments for the authors in this box rather than uploading
your report as an attachment. Please only upload as attachments annotated
versions of manuscripts, graphs, supporting materials or other aspects of your
report which cannot be included in a text format.
Please overwrite this text when adding your comments to the authors.
This is retrospective review of a large series of patients undergoing LigaSure
haemorrhoidectomy. 
The size of the study, the focus on older patients, the
attention to detail in peri-operative and post -operative care are all excellent. 
It is
certainly a larger series and better observed than many reported in other
publications. In principle I would like to see this study published.
My main concerns relate to the preparation of the manuscript. 
The text is, in
many places, difficult to read as the sentence construction, syntax and grammar
are awkward and in places difficult to understand. 
In other places the text is
repetitive and the paper would be easier to read and more understandable if re-
written. 
There are also mistakes of spelling, punctuation and citation of
references. Furthermore the authors use abbreviations which are either totally
inappropriate in an academic work or which are not explained. 
I did start to make
a list for the authors but after finding about 20 such errors on the first page, and
being unable to edit the PDF directly - then it became an inordinate task to try to
correct all of these. 
There are many inconsistences which show a lack of
attention to the writing - for example the name of the procedure itself is written
in 3 different ways on the first page! - LigaSure haemorrhoidectomy,
LigaSurehaemorrhoidectomy, Ligasurehaemorrhoidectomy. 
Obviously only one
of these is correct and should be used throughout the paper.
There are also problems with the presentation of materials and methods and
results. 
The M&M section contains some points of explanation regarding post
operative medication which would be better placed in the Discussion section.
The results section is hard to navigate with a long narrative regarding each
result. 
A shorter summary with reference to the relevant table would be more
helpful. 
There is also confusion regarding post operative analgesia - in the M&M
section Diclofenac is described, but in the results section usage of ketoprofen is
discussed - with no mention of it as one of the choice of analgesics.
The discussion section repeats quite a significant amount of the results section
and again could do with a substantial re-write.
I will recommend to the editor that although this is a large and well conducted
clinical study, the manuscript should undergo a significant re-write in order to
make it more readable, remove the numerous grammatical and spelling errors,
and clarify the points mentioned above. 
I would also suggest that the manuscript
be submitted to a copy editor in a Word format so that changes can be made
easily and tracked. 
It is extremely difficult for an academic reviewer to make the
number of changes that would be required to raise this paper to an acceptable
publishable standard on a PDF file.
Publons Reviewer Recognition
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review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted
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and update your profile 
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register in order for them to be able to recognize your review on your new
profile page. Publons may use the Review Data to generate derivative metadata
for the benefit of Publons and you as a reviewer, carefully considering the
sensitivity of such information. For example, Publons may verify your record as
a reviewer by updating your profile published on its webservice if you have
registered for such service or help editors to identify candidate reviewers. Please
find the details of processing in Publons’ privacy policy
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Yes
Declaration of competing interests
Please complete a declaration of competing
interests, considering the following questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare I have no competing interests
Reviewer Publication Consent.
 I agree for my report to be made available
under an Open Access Creative Commons CC-BY License (
http://creativecommons.org/licenses/by/4.0
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the
editorial office before completing the review.
If you wish, you can include your
name in your published report. Please note you must decide whether to include
your name at the start of the process and confirm this decision whenever
prompted. If you change your decision later, we will not be able to publish your
name.
I agree to the terms of the CC-BY 4.0 license; please 
do not
 publish my name
with my report. (default)
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
No
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
No
Reviewer’s report
Title: 
Surgical Outcomes of LigaSure Hemorrhoidectomy in the Elderly
Population: A retrospective cohort study
Version: 
0 
Date: 
11 Mar 2021
Reviewer's report:
Please include all comments for the authors in this box rather than uploading
your report as an attachment. Please only upload as attachments annotated
versions of manuscripts, graphs, supporting materials or other aspects of your
report which cannot be included in a text format.
Please overwrite this text when adding your comments to the authors.
This is retrospective review of a large series of patients undergoing LigaSure
haemorrhoidectomy. 
The size of the study, the focus on older patients, the
attention to detail in peri-operative and post -operative care are all excellent. 
It is
certainly a larger series and better observed than many reported in other
publications. In principle I would like to see this study published.
My main concerns relate to the preparation of the manuscript. 
The text is, in
many places, difficult to read as the sentence construction, syntax and grammar
are awkward and in places difficult to understand. 
In other places the text is
repetitive and the paper would be easier to read and more understandable if re-
written. 
There are also mistakes of spelling, punctuation and citation of
references. Furthermore the authors use abbreviations which are either totally
inappropriate in an academic work or which are not explained. 
I did start to make
a list for the authors but after finding about 20 such errors on the first page, and
being unable to edit the PDF directly - then it became an inordinate task to try to
correct all of these. 
There are many inconsistences which show a lack of
attention to the writing - for example the name of the procedure itself is written
in 3 different ways on the first page! - LigaSure haemorrhoidectomy,
LigaSurehaemorrhoidectomy, Ligasurehaemorrhoidectomy. 
Obviously only one
of these is correct and should be used throughout the paper.
There are also problems with the presentation of materials and methods and
results. 
The M&M section contains some points of explanation regarding post
operative medication which would be better placed in the Discussion section.
The results section is hard to navigate with a long narrative regarding each
result. 
A shorter summary with reference to the relevant table would be more
helpful. 
There is also confusion regarding post operative analgesia - in the M&M
section Diclofenac is described, but in the results section usage of ketoprofen is
discussed - with no mention of it as one of the choice of analgesics.
The discussion section repeats quite a significant amount of the results section
and again could do with a substantial re-write.
I will recommend to the editor that although this is a large and well conducted
clinical study, the manuscript should undergo a significant re-write in order to
make it more readable, remove the numerous grammatical and spelling errors,
and clarify the points mentioned above. 
I would also suggest that the manuscript
be submitted to a copy editor in a Word format so that changes can be made
easily and tracked. 
It is extremely difficult for an academic reviewer to make the
number of changes that would be required to raise this paper to an acceptable
publishable standard on a PDF file.
Publons Reviewer Recognition
. Springer Nature can send verification of this
review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted
to Publons after the final decision on the manuscript has been made. If you have
already registered at Publons, they will notify you of the receipt of this review
and update your profile 
as per your settings and their policy. If you are not
registered with Publons, you will receive an email from them asking you to
register in order for them to be able to recognize your review on your new
profile page. Publons may use the Review Data to generate derivative metadata
for the benefit of Publons and you as a reviewer, carefully considering the
sensitivity of such information. For example, Publons may verify your record as
a reviewer by updating your profile published on its webservice if you have
registered for such service or help editors to identify candidate reviewers. Please
find the details of processing in Publons’ privacy policy
https://publons.com/about/terms
Yes
Declaration of competing interests
Please complete a declaration of competing
interests, considering the following questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare I have no competing interests
Reviewer Publication Consent.
 I agree for my report to be made available
under an Open Access Creative Commons CC-BY License (
http://creativecommons.org/licenses/by/4.0
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the
editorial office before completing the review.
If you wish, you can include your
name in your published report. Please note you must decide whether to include
your name at the start of the process and confirm this decision whenever
prompted. If you change your decision later, we will not be able to publish your
name.
I agree to the terms of the CC-BY 4.0 license; please 
do not
 publish my name
with my report. (default)
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
No
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
No
Please review this paper.
user
Reviewer’s report
Title: 
Surgical Outcomes of LigaSure Hemorrhoidectomy in the Elderly
Population: A retrospective cohort study
Version: 
0 
Date: 
11 Mar 2021
Reviewer's report:
Please include all comments for the authors in this box rather than uploading
your report as an attachment. Please only upload as attachments annotated
versions of manuscripts, graphs, supporting materials or other aspects of your
report which cannot be included in a text format.
Please overwrite this text when adding your comments to the authors.
This is retrospective review of a large series of patients undergoing LigaSure
haemorrhoidectomy. 
The size of the study, the focus on older patients, the
attention to detail in peri-operative and post -operative care are all excellent. 
It is
certainly a larger series and better observed than many reported in other
publications. In principle I would like to see this study published.
My main concerns relate to the preparation of the manuscript. 
The text is, in
many places, difficult to read as the sentence construction, syntax and grammar
are awkward and in places difficult to understand. 
In other places the text is
repetitive and the paper would be easier to read and more understandable if re-
written. 
There are also mistakes of spelling, punctuation and citation of
references. Furthermore the authors use abbreviations which are either totally
inappropriate in an academic work or which are not explained. 
I did start to make
a list for the authors but after finding about 20 such errors on the first page, and
being unable to edit the PDF directly - then it became an inordinate task to try to
correct all of these. 
There are many inconsistences which show a lack of
attention to the writing - for example the name of the procedure itself is written
in 3 different ways on the first page! - LigaSure haemorrhoidectomy,
LigaSurehaemorrhoidectomy, Ligasurehaemorrhoidectomy. 
Obviously only one
of these is correct and should be used throughout the paper.
There are also problems with the presentation of materials and methods and
results. 
The M&M section contains some points of explanation regarding post
operative medication which would be better placed in the Discussion section.
The results section is hard to navigate with a long narrative regarding each
result. 
A shorter summary with reference to the relevant table would be more
helpful. 
There is also confusion regarding post operative analgesia - in the M&M
section Diclofenac is described, but in the results section usage of ketoprofen is
discussed - with no mention of it as one of the choice of analgesics.
The discussion section repeats quite a significant amount of the results section
and again could do with a substantial re-write.
I will recommend to the editor that although this is a large and well conducted
clinical study, the manuscript should undergo a significant re-write in order to
make it more readable, remove the numerous grammatical and spelling errors,
and clarify the points mentioned above. 
I would also suggest that the manuscript
be submitted to a copy editor in a Word format so that changes can be made
easily and tracked. 
It is extremely difficult for an academic reviewer to make the
number of changes that would be required to raise this paper to an acceptable
publishable standard on a PDF file.
Publons Reviewer Recognition
. Springer Nature can send verification of this
review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted
to Publons after the final decision on the manuscript has been made. If you have
already registered at Publons, they will notify you of the receipt of this review
and update your profile 
as per your settings and their policy. If you are not
registered with Publons, you will receive an email from them asking you to
register in order for them to be able to recognize your review on your new
profile page. Publons may use the Review Data to generate derivative metadata
for the benefit of Publons and you as a reviewer, carefully considering the
sensitivity of such information. For example, Publons may verify your record as
a reviewer by updating your profile published on its webservice if you have
registered for such service or help editors to identify candidate reviewers. Please
find the details of processing in Publons’ privacy policy
https://publons.com/about/terms
Yes
Declaration of competing interests
Please complete a declaration of competing
interests, considering the following questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare I have no competing interests
Reviewer Publication Consent.
 I agree for my report to be made available
under an Open Access Creative Commons CC-BY License (
http://creativecommons.org/licenses/by/4.0
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the
editorial office before completing the review.
If you wish, you can include your
name in your published report. Please note you must decide whether to include
your name at the start of the process and confirm this decision whenever
prompted. If you change your decision later, we will not be able to publish your
name.
I agree to the terms of the CC-BY 4.0 license; please 
do not
 publish my name
with my report. (default)
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
No
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
No
assistant