A systematic review of the literature assessing the outcomes of stapled haemorrhoidopexy versus open haemorrhoidectomy
BACKGROUND: Symptomatic haemorrhoids affect a large number of patients throughout the world. The aim of this systematic review was to compare the surgical outcomes of stapled haemorrhoidopexy (SH) versus open haemorrhoidectomy (OH) over a 20-year period.
METHODS: Randomized controlled trials published between January 1998 and January 2019 were extracted from Pubmed using defined search criteria. Study characteristics and outcomes in the form of short-term and long-term complications of the two techniques were analyzed. Any changes in trend of outcomes over time were assessed by comparing article groups 1998-2008 and 2009-2019.
RESULTS: Twenty-nine and 9 relevant articles were extracted for the 1998-2008 (period 1) and 2009-2019 (period 2) cohorts, respectively. Over the two time periods, SH was found to be a safe procedure, associated with statistically reduced operative time (in 13/21 studies during period 1 and in 3/8 studies during period 2), statistically less intraoperative bleeding (3/7 studies in period 1 and 1/1 study in period 2) and consistently less early postoperative pain on the visual analogue scale (12/15 studies in period 1 and 4/5 studies in period 2) resulting in shorter hospital stay (12/20 studies in period 1 and 2/2 studies in period 2) at the expense of a higher cost. In the longer term, although chronic pain in SH and OH patents is comparable, patient satisfaction with SH may decline with time and at 2-year follow-up OH appeared to be associated with greater patient satisfaction.
CONCLUSIONS: SH appears to be safe with potential advantages, at least in the short term, but the evidence is lacking at the moment to suggest its routine use in clinical practice.
| Errataetall: |
CommentIn: Tech Coloproctol. 2021 Aug;25(8):991-992. - PMID 33587213 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:25 |
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| Enthalten in: |
Techniques in coloproctology - 25(2021), 1 vom: 24. Jan., Seite 19-33 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ruan, Q Z [VerfasserIn] |
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| Links: |
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| Themen: |
Haemorrhoidectomy |
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| Anmerkungen: |
Date Completed 27.04.2021 Date Revised 29.07.2021 published: Print-Electronic CommentIn: Tech Coloproctol. 2021 Aug;25(8):991-992. - PMID 33587213 Citation Status MEDLINE |
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| doi: |
10.1007/s10151-020-02314-6 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 500 | |a CommentIn: Tech Coloproctol. 2021 Aug;25(8):991-992. - PMID 33587213 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Symptomatic haemorrhoids affect a large number of patients throughout the world. The aim of this systematic review was to compare the surgical outcomes of stapled haemorrhoidopexy (SH) versus open haemorrhoidectomy (OH) over a 20-year period | ||
| 520 | |a METHODS: Randomized controlled trials published between January 1998 and January 2019 were extracted from Pubmed using defined search criteria. Study characteristics and outcomes in the form of short-term and long-term complications of the two techniques were analyzed. Any changes in trend of outcomes over time were assessed by comparing article groups 1998-2008 and 2009-2019 | ||
| 520 | |a RESULTS: Twenty-nine and 9 relevant articles were extracted for the 1998-2008 (period 1) and 2009-2019 (period 2) cohorts, respectively. Over the two time periods, SH was found to be a safe procedure, associated with statistically reduced operative time (in 13/21 studies during period 1 and in 3/8 studies during period 2), statistically less intraoperative bleeding (3/7 studies in period 1 and 1/1 study in period 2) and consistently less early postoperative pain on the visual analogue scale (12/15 studies in period 1 and 4/5 studies in period 2) resulting in shorter hospital stay (12/20 studies in period 1 and 2/2 studies in period 2) at the expense of a higher cost. In the longer term, although chronic pain in SH and OH patents is comparable, patient satisfaction with SH may decline with time and at 2-year follow-up OH appeared to be associated with greater patient satisfaction | ||
| 520 | |a CONCLUSIONS: SH appears to be safe with potential advantages, at least in the short term, but the evidence is lacking at the moment to suggest its routine use in clinical practice | ||
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| 650 | 4 | |a Systematic Review | |
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| 650 | 4 | |a Outcomes | |
| 650 | 4 | |a Stapled | |
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| 700 | 1 | |a Wexner, S D |e verfasserin |4 aut | |
| 700 | 1 | |a Banerjee, S |e verfasserin |4 aut | |
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