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Related Experiment Videos

Stapled versus conventional surgery for hemorrhoids.

K J Lumb, P H D Colquhoun, R A Malthaner

  • 1University of Western Ontario, Department of Surgery, 339 Windermere Rd. Rm C8-114, London, Ontario, Canada. sjayaram@uwo.ca

The Cochrane Database of Systematic Reviews
|October 21, 2006
PubMed
Summary
This summary is machine-generated.

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Stapled hemorrhoidopexy (SH) leads to higher recurrence and prolapse rates compared to conventional hemorrhoidectomy (CH). CH surgery is more effective for long-term symptom relief and reducing the need for further procedures.

Area of Science:

  • Gastroenterology and Surgical Innovation
  • Anorectal Disorders and Treatment Efficacy
  • Comparative Surgical Outcomes Research

Background:

  • Hemorrhoids are common anorectal disorders, with Milligan-Morgan open hemorrhoidectomy as the gold standard.
  • Circular stapled hemorrhoidopexy (SH) emerged as an alternative, initially showing promise for reduced pain and quicker recovery.
  • Previous reviews indicated a higher risk of recurrence and long-term symptoms with SH compared to conventional hemorrhoidectomy (CH).

Purpose of the Study:

  • To compare the outcomes of circular stapling devices versus conventional excisional techniques for symptomatic hemorrhoids.
  • To evaluate differences in efficacy and patient outcomes between stapled hemorrhoidopexy (SH) and conventional hemorrhoidectomy (CH).

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs) published from 1998 to December 2009.

Related Experiment Videos

  • Searched major electronic databases including MEDLINE, EMBASE, and CENTRAL.
  • Included RCTs comparing SH to CH with a minimum follow-up of 6 months; data analyzed using random effects models.

    • Main Results:

    • SH significantly increased the risk of recurrent hemorrhoids (OR 3.22) and prolapse symptoms (OR 2.65) compared to CH.
    • Patients undergoing SH were more likely to require additional operative procedures (OR 2.75).
    • CH surgery resulted in a higher proportion of asymptomatic patients (OR 0.59) and favored CH in most other clinical parameters.

    Conclusions:

    • Despite potential short-term benefits, stapled hemorrhoidopexy (SH) is associated with significantly higher long-term recurrence and prolapse rates.
    • Conventional hemorrhoidectomy (CH) demonstrates superior long-term efficacy in managing hemorrhoids and reducing the need for re-intervention.
    • Further research may be warranted, but current evidence suggests CH offers better outcomes for symptomatic hemorrhoid management.