Stapled technique for acute thrombosed hemorrhoids: a randomized, controlled trial with long-term results

Area of Science:

• Colorectal Surgery
• Surgical Innovation
• Hemorrhoid Treatment

Background:

• Hemorrhoidal disease is a common condition.
• Acute thrombosed hemorrhoids often require surgical intervention.
• Conventional hemorrhoidectomy can be associated with significant postoperative pain and prolonged recovery.

Purpose of the Study:

• To compare the efficacy and safety of stapled hemorrhoidectomy (PPH) versus conventional open hemorrhoidectomy for acute thrombosed hemorrhoids.
• To evaluate short-term and long-term outcomes, including pain, recovery, recurrence, and patient satisfaction.

Main Methods:

• A randomized controlled trial involving 41 patients with acute thrombosed hemorrhoids.
• Patients were assigned to either stapled hemorrhoidectomy (n=21) or open hemorrhoidectomy (n=20).
• Perioperative data, complications, pain intensity, recurrence, continence, and patient satisfaction were assessed during follow-up.

Main Results:

• The stapled hemorrhoidectomy group experienced significantly less pain in the first postoperative week (P=0.02).
• Patients undergoing stapled hemorrhoidectomy showed faster recovery, including reduced time to become analgesic-free (P<0.01), pain-free (P=0.01), and return to work (P=0.01).
• Stapled hemorrhoidectomy resulted in quicker wound healing (P<0.01), fewer long-term recurrences (P=0.02), and higher overall patient satisfaction (P<0.01).

Conclusions:

• Stapled hemorrhoidectomy is a safe and effective treatment for acute thrombosed hemorrhoids.
• Emergency stapled hemorrhoidectomy provides significant short-term advantages over conventional excision, including reduced pain and faster recovery.
• The procedure demonstrates excellent long-term outcomes and high patient satisfaction.