Stapled haemorrhoidopexy for the treatment of haemorrhoids: a systematic review
Objective This systematic review aimed to evaluate the short‐ and long‐term safety, efficacy and costs of stapled haemorrhoidopexy (SH) compared with conventional haemorrhoidectomy. Method We searched 26 electronic databases and websites for studies in any language up to July 2006. Inclusion crite...
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| Veröffentlicht in: | Colorectal disease 2009-03, Vol.11 (3), p.233-243 |
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| creator | Burch, J. Epstein, D. Baba-Akbari Sari, A. Weatherly, H. Jayne, D. Fox, D. Woolacott, N. |
| description | Objective This systematic review aimed to evaluate the short‐ and long‐term safety, efficacy and costs of stapled haemorrhoidopexy (SH) compared with conventional haemorrhoidectomy.
Method We searched 26 electronic databases and websites for studies in any language up to July 2006. Inclusion criteria were predefined, and each stage of the review process was conducted in duplicate.
Results Twenty‐seven randomized controlled trials were included (n = 2279). All had some methodological flaws. Postoperatively, 19 trials (95%) reported less pain, 17 (89%) reported a shorter operating time, 14 (88%) a shorter hospital stay, and 14 (93%) a shorter convalescence time following SH. However, prolapse was significantly more common after SH (OR 3.38; 95% CI: 1.00, 11.47). In the longer term, prolapse was significantly more common after SH (OR 4.34; 95% CI: 1.67, 11.28) as was reintervention for prolapse (OR 6.78; 95% CI: 2.00, 23.00). There were no differences in the rate or type of complications. Conventional haemorrhoidectomy and SH had similar costs during the initial admission.
Conclusion Compared with conventional haemorrhoidectomy, SH resulted in less postoperative pain, shorter operating time, a shorter hospital stay, and a shorter convalescence, but a higher rate of prolapse and reintervention for prolapse. |
| doi_str_mv | 10.1111/j.1463-1318.2008.01638.x |
| format | Article |
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Method We searched 26 electronic databases and websites for studies in any language up to July 2006. Inclusion criteria were predefined, and each stage of the review process was conducted in duplicate.
Results Twenty‐seven randomized controlled trials were included (n = 2279). All had some methodological flaws. Postoperatively, 19 trials (95%) reported less pain, 17 (89%) reported a shorter operating time, 14 (88%) a shorter hospital stay, and 14 (93%) a shorter convalescence time following SH. However, prolapse was significantly more common after SH (OR 3.38; 95% CI: 1.00, 11.47). In the longer term, prolapse was significantly more common after SH (OR 4.34; 95% CI: 1.67, 11.28) as was reintervention for prolapse (OR 6.78; 95% CI: 2.00, 23.00). There were no differences in the rate or type of complications. Conventional haemorrhoidectomy and SH had similar costs during the initial admission.
Conclusion Compared with conventional haemorrhoidectomy, SH resulted in less postoperative pain, shorter operating time, a shorter hospital stay, and a shorter convalescence, but a higher rate of prolapse and reintervention for prolapse.</description><identifier>ISSN: 1462-8910</identifier><identifier>EISSN: 1463-1318</identifier><identifier>DOI: 10.1111/j.1463-1318.2008.01638.x</identifier><identifier>PMID: 18637932</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Blood Loss, Surgical - physiopathology ; circular stapler ; Colorectal Surgery - adverse effects ; Colorectal Surgery - methods ; Female ; Ferguson ; Follow-Up Studies ; Haemorrhoidectomy ; Hemorrhoids - diagnosis ; Hemorrhoids - surgery ; Hospital Costs ; Humans ; Length of Stay ; Male ; Milligan-Morgan ; Minimally Invasive Surgical Procedures - economics ; Minimally Invasive Surgical Procedures - methods ; Pain, Postoperative - physiopathology ; Patient Satisfaction ; Postoperative Hemorrhage - physiopathology ; PPH ; Randomized Controlled Trials as Topic ; Recurrence ; Surgical Stapling - adverse effects ; Surgical Stapling - economics ; Surgical Stapling - methods ; Sutures ; Treatment Outcome</subject><ispartof>Colorectal disease, 2009-03, Vol.11 (3), p.233-243</ispartof><rights>Journal Compilation © 2009 The Association of Coloproctology of Great Britain and Ireland. No claim to original US government works</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4068-268a03a0498078c8a8edab1b1e20c5d3b7ecb6f69ff1a76819a083a44eca98c63</citedby><cites>FETCH-LOGICAL-c4068-268a03a0498078c8a8edab1b1e20c5d3b7ecb6f69ff1a76819a083a44eca98c63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1463-1318.2008.01638.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1463-1318.2008.01638.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18637932$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Burch, J.</creatorcontrib><creatorcontrib>Epstein, D.</creatorcontrib><creatorcontrib>Baba-Akbari Sari, A.</creatorcontrib><creatorcontrib>Weatherly, H.</creatorcontrib><creatorcontrib>Jayne, D.</creatorcontrib><creatorcontrib>Fox, D.</creatorcontrib><creatorcontrib>Woolacott, N.</creatorcontrib><title>Stapled haemorrhoidopexy for the treatment of haemorrhoids: a systematic review</title><title>Colorectal disease</title><addtitle>Colorectal Dis</addtitle><description>Objective This systematic review aimed to evaluate the short‐ and long‐term safety, efficacy and costs of stapled haemorrhoidopexy (SH) compared with conventional haemorrhoidectomy.
Method We searched 26 electronic databases and websites for studies in any language up to July 2006. Inclusion criteria were predefined, and each stage of the review process was conducted in duplicate.
Results Twenty‐seven randomized controlled trials were included (n = 2279). All had some methodological flaws. Postoperatively, 19 trials (95%) reported less pain, 17 (89%) reported a shorter operating time, 14 (88%) a shorter hospital stay, and 14 (93%) a shorter convalescence time following SH. However, prolapse was significantly more common after SH (OR 3.38; 95% CI: 1.00, 11.47). In the longer term, prolapse was significantly more common after SH (OR 4.34; 95% CI: 1.67, 11.28) as was reintervention for prolapse (OR 6.78; 95% CI: 2.00, 23.00). There were no differences in the rate or type of complications. Conventional haemorrhoidectomy and SH had similar costs during the initial admission.
Conclusion Compared with conventional haemorrhoidectomy, SH resulted in less postoperative pain, shorter operating time, a shorter hospital stay, and a shorter convalescence, but a higher rate of prolapse and reintervention for prolapse.</description><subject>Blood Loss, Surgical - physiopathology</subject><subject>circular stapler</subject><subject>Colorectal Surgery - adverse effects</subject><subject>Colorectal Surgery - methods</subject><subject>Female</subject><subject>Ferguson</subject><subject>Follow-Up Studies</subject><subject>Haemorrhoidectomy</subject><subject>Hemorrhoids - diagnosis</subject><subject>Hemorrhoids - surgery</subject><subject>Hospital Costs</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Milligan-Morgan</subject><subject>Minimally Invasive Surgical Procedures - economics</subject><subject>Minimally Invasive Surgical Procedures - methods</subject><subject>Pain, Postoperative - physiopathology</subject><subject>Patient Satisfaction</subject><subject>Postoperative Hemorrhage - physiopathology</subject><subject>PPH</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Recurrence</subject><subject>Surgical Stapling - adverse effects</subject><subject>Surgical Stapling - economics</subject><subject>Surgical Stapling - methods</subject><subject>Sutures</subject><subject>Treatment Outcome</subject><issn>1462-8910</issn><issn>1463-1318</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkFtLwzAUgIMoXqZ_QfLkW2vSdGnqgyCdl8lw4AUfw2l6yjpbO5NOt39vuw710bzkQL7zBT5CKGc-b8_53OehFB4XXPkBY8pnXArlr3bI4c_D7mYOPBVzdkCOnJuzloq42icHXEkRxSI4JNOnBhYlZnQGWNXWzuoiqxe4WtO8trSZIW0sQlPhe0Pr_C_lLihQt3YNVtAUhlr8LPDrmOzlUDo82d4D8nJz_ZzceZPp7Ti5mngmZFJ5gVTABLAwVixSRoHCDFKecgyYGWYijdCkMpdxnnOIpOIxMCUgDNFArIwUA3LWexe2_liia3RVOINlCe9YL52WMpY8CFgLqh40tnbOYq4XtqjArjVnuoup57prprtmuoupNzH1ql093f6xTCvMfhe39Vrgsge-ihLX_xbrZDoad2Mr8HpB0WZc_QjAvmkZiWioXx9uNY-Hj_fJKNSB-AbguZML</recordid><startdate>200903</startdate><enddate>200903</enddate><creator>Burch, J.</creator><creator>Epstein, D.</creator><creator>Baba-Akbari Sari, A.</creator><creator>Weatherly, H.</creator><creator>Jayne, D.</creator><creator>Fox, D.</creator><creator>Woolacott, N.</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200903</creationdate><title>Stapled haemorrhoidopexy for the treatment of haemorrhoids: a systematic review</title><author>Burch, J. ; Epstein, D. ; Baba-Akbari Sari, A. ; Weatherly, H. ; Jayne, D. ; Fox, D. ; Woolacott, N.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4068-268a03a0498078c8a8edab1b1e20c5d3b7ecb6f69ff1a76819a083a44eca98c63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Blood Loss, Surgical - physiopathology</topic><topic>circular stapler</topic><topic>Colorectal Surgery - adverse effects</topic><topic>Colorectal Surgery - methods</topic><topic>Female</topic><topic>Ferguson</topic><topic>Follow-Up Studies</topic><topic>Haemorrhoidectomy</topic><topic>Hemorrhoids - diagnosis</topic><topic>Hemorrhoids - surgery</topic><topic>Hospital Costs</topic><topic>Humans</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Milligan-Morgan</topic><topic>Minimally Invasive Surgical Procedures - economics</topic><topic>Minimally Invasive Surgical Procedures - methods</topic><topic>Pain, Postoperative - physiopathology</topic><topic>Patient Satisfaction</topic><topic>Postoperative Hemorrhage - physiopathology</topic><topic>PPH</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Recurrence</topic><topic>Surgical Stapling - adverse effects</topic><topic>Surgical Stapling - economics</topic><topic>Surgical Stapling - methods</topic><topic>Sutures</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Burch, J.</creatorcontrib><creatorcontrib>Epstein, D.</creatorcontrib><creatorcontrib>Baba-Akbari Sari, A.</creatorcontrib><creatorcontrib>Weatherly, H.</creatorcontrib><creatorcontrib>Jayne, D.</creatorcontrib><creatorcontrib>Fox, D.</creatorcontrib><creatorcontrib>Woolacott, N.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Burch, J.</au><au>Epstein, D.</au><au>Baba-Akbari Sari, A.</au><au>Weatherly, H.</au><au>Jayne, D.</au><au>Fox, D.</au><au>Woolacott, N.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Stapled haemorrhoidopexy for the treatment of haemorrhoids: a systematic review</atitle><jtitle>Colorectal disease</jtitle><addtitle>Colorectal Dis</addtitle><date>2009-03</date><risdate>2009</risdate><volume>11</volume><issue>3</issue><spage>233</spage><epage>243</epage><pages>233-243</pages><issn>1462-8910</issn><eissn>1463-1318</eissn><abstract>Objective This systematic review aimed to evaluate the short‐ and long‐term safety, efficacy and costs of stapled haemorrhoidopexy (SH) compared with conventional haemorrhoidectomy.
Method We searched 26 electronic databases and websites for studies in any language up to July 2006. Inclusion criteria were predefined, and each stage of the review process was conducted in duplicate.
Results Twenty‐seven randomized controlled trials were included (n = 2279). All had some methodological flaws. Postoperatively, 19 trials (95%) reported less pain, 17 (89%) reported a shorter operating time, 14 (88%) a shorter hospital stay, and 14 (93%) a shorter convalescence time following SH. However, prolapse was significantly more common after SH (OR 3.38; 95% CI: 1.00, 11.47). In the longer term, prolapse was significantly more common after SH (OR 4.34; 95% CI: 1.67, 11.28) as was reintervention for prolapse (OR 6.78; 95% CI: 2.00, 23.00). There were no differences in the rate or type of complications. Conventional haemorrhoidectomy and SH had similar costs during the initial admission.
Conclusion Compared with conventional haemorrhoidectomy, SH resulted in less postoperative pain, shorter operating time, a shorter hospital stay, and a shorter convalescence, but a higher rate of prolapse and reintervention for prolapse.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>18637932</pmid><doi>10.1111/j.1463-1318.2008.01638.x</doi><tpages>11</tpages></addata></record> |
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| ispartof | Colorectal disease, 2009-03, Vol.11 (3), p.233-243 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Blood Loss, Surgical - physiopathology circular stapler Colorectal Surgery - adverse effects Colorectal Surgery - methods Female Ferguson Follow-Up Studies Haemorrhoidectomy Hemorrhoids - diagnosis Hemorrhoids - surgery Hospital Costs Humans Length of Stay Male Milligan-Morgan Minimally Invasive Surgical Procedures - economics Minimally Invasive Surgical Procedures - methods Pain, Postoperative - physiopathology Patient Satisfaction Postoperative Hemorrhage - physiopathology PPH Randomized Controlled Trials as Topic Recurrence Surgical Stapling - adverse effects Surgical Stapling - economics Surgical Stapling - methods Sutures Treatment Outcome |
| title | Stapled haemorrhoidopexy for the treatment of haemorrhoids: a systematic review |
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