A systematic review of stapled haemorrhoidectomy
Sutherland LM, Sweeney JL, Bokey EL, Childs RA, Waxman BP, Roberts AK, Maddern GJ
Record ID 32002000395
English
Authors' objectives:
To compare the safety and efficacy of stapled haemorrhoidectomy and conventional methods of haemorrhoidectomy.
Authors' results and conclusions:
There was reasonably clear evidence in favour of the stapled procedure for bleeding at two weeks and length of hospital stay. Other less robust results in favour of the stapled haemorrhoidectomy related to pain, bleeding, anal discharge, wound healing, tenderness to per rectal examination, incontinence scores, earlier return of bowel function, analgesic requirement, and resumption of normal activities. On the other hand, one trial showed that prolapse occurred at significantly higher rates in the stapled group, up to 19 months after surgery. Since this is one of the indications for surgery, its persistence may be seen as treatment failure. Outcome measures for pain and bleeding varied greatly between studies, so very few conclusions could be made. This is of concern as both of these symptoms are of primary importance for patients undergoing haemorrhoidectomy.
Authors' recommendations:
Circular stapled haemorrhoidectomy appears to be at least as safe as conventional approaches for third and fourth degree haemorrhoids. However, the evidence base was inadequate to compare the efficacy of these procedures. It was recommended that surgeons practising stapled haemorrhoidectomy should conduct a careful audit of their results. It was also suggested that, as a minimum requirement, surgeons wishing to use the stapled technique of haemorrhoidectomy should undergo appropriate training and supervised instruction in accordance with training guidelines developed by The Colorectal Surgical Society of Australasia.
Authors' methods:
Systematic review
Details
Project Status:
Completed
URL for project:
http://www.surgeons.org/asernip-s/
Year Published:
2002
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Australia
MeSH Terms
- Surgical Stapling
- Sutures
- Hemorrhoids
Contact
Organisation Name:
Australian Safety and Efficacy Register of New Interventional Procedures-Surgical
Contact Address:
ASERNIP-S 24 King William Street, Kent Town SA 5067 Australia Tel: +61 8 8219 0900
Contact Name:
racs.asernip@surgeons.org
Contact Email:
racs.asernip@surgeons.org
Copyright:
Australian Safety and Efficacy Register of New Interventional Procedures - Surgical
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