Navigation Links
Hemorrhoid Stapling Has More Long-Term Risks Than Surgical Removal

Stapling of hemorrhoids — a relatively new and increasingly popular procedure — is associated with a higher risk of recurrence and prolapse than conventional hemorrhoid removal surgery, // investigators report in a comprehensive review of clinical studies.

In contrast to removal (excisional) surgery, circular stapling (hemorrhoidopexy) does not remove hemorrhoids but treats them by inhibiting blood flow to the tissue.

“This study shows that stapled hemorrhoidopexy is associated with a greater risk of hemorrhoid recurrence and the symptom of prolapse in long-term follow-up compared to conventional excisional surgery,” said lead investigator Shiva Jayaraman Colquhoun, M.D.

“If surgeons are to offer this novel technique to their patients, there should be an informed discussion of the risks,” said Colquhoun, a resident in general surgery at the Schulich School of Medicine and Dentistry, University of Western Ontario, in Canada.

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing trials on a topic.

Hemorrhoid disease is known to affect more than 15 million people annually in the United States, a number believed to be low since an estimated one-third of patients with symptoms of hemorrhoids do not seek a physician’s care for the condition.

Stapling was introduced in the late 1990s, and in some small studies was shown to be less painful and faster to heal than conventional surgery. A few short-term studies — with less than a year of follow-up — suggested that stapling is equal to excision for controlling further hemorrhoid symptoms. These results helped lead to growing demand for the stapling procedure.

For this new review , the investigators analyzed seven randomized clinical trials involving 537 participants and found that patients who had undergone circular stapling were significantly more likely to have recurrent hemorrhoids in the long term than those whose hemorrhoids were surgically removed.

Out of 269 stapling patients, 23 suffered recurrences, compared with four recurrences among 268 patients in the surgical-removal group.

The investigators also found that a significantly higher proportion of stapling subjects complained of prolapse (protrusion outside the anus) both within 12 months and longer.

In favor of stapling, results were better in terms of less pain, itching or bowel-movement urgency; however, these were data “trends” that did not reach the level of significance All other clinical outcomes favored excisional surgery.

The authors suggested that rather than simply offering stapling to all patients with hemorrhoids, there may be a subset of patients for whom it is more beneficial, and that identifying this subset will require further research. “If hemorrhoid recurrence and prolapse are the most important clinical outcomes,” they said, “then conventional excisional surgery remains the ‘gold standard’ in the surgical treatment of internal hemorrhoids.”

“This paper directly confronts the major concern with stapled hemorrhoidectomy, namely the long-term outcome,” said Joshua Katz, M.D., in private practice with Montgomery Colorectal Surgery in Rockville, Md. “Proponents of this procedure argue it provides similar results to the open procedure with less pain, less disability and more rapid return to work. This paper states that the decreased pain and disability may entail increased risk of recurrence. As the authors note, patients must be advised of this increased risk.”

“In all fairness,” Katz added, “the increased risk, although statistically significant, is still clinically acceptable, 23 of 269 [stap led] patients versus four of 268 patients with conventional hemorrhoidectomy. Physicians and patients will therefore choose between a procedure carrying increased morbidity and disability with a low recurrence rate, and a procedure with decreased morbidity and disability and a higher recurrence rate.”
Source-Newswise
SRM
'"/>




Related medicine news :

1. Pancreatitis: Minimially Invasive Procedure Offers Long-Term Pain Relief
2. Long-Term Survival can be Predicted by a Simple Lung Test
3. Lung Therapy Found To Have Long-Term Side Effects
4. Long-Term Benefits Of Statins Questioned
5. Clue to Link Between Obesity and Long-Term Memory Discovered
6. Drug Regulators Need To Think In Long-Term, Say Charities
7. Aspirin and other NSAIDS Proved Less Effective in Long-Term Smokers
8. Pharmacists to take over Treatment of Long-Term Illnesses
9. Kyphoplasty Yields Good Long-Term Improvement for Spinal Fractures
10. Long-Term Outcomes for Prostate Cancer Show IMRT Curative
11. IMRT Versus 3D CRT For Prostate Cancer, New Long-Term Data Assesses Side Effects
Post Your Comments:
*Name:
*Comment:
*Email:


(Date:12/7/2016)... ... December 07, 2016 , ... They are musicians and librarians, fashion ... brothers and fathers, from New England and around the nation. What do they have ... brought together in a beautiful and compelling new photographic exhibit debuting Friday, December 9 ...
(Date:12/7/2016)... TX (PRWEB) , ... December 07, 2016 , ... ... offering insurance and financial planning services to families and business owners in the ... funds on behalf of the Dallas Fallen Officer Foundation. , Established in 2009 ...
(Date:12/7/2016)... ... 07, 2016 , ... Sharon Kleyne, host of the nationally syndicated radio program, ... Voice of America, declared on her radio program in November 2016 the need to ... these bullies attack leaders in corporate America, they are trying to take advantage of ...
(Date:12/7/2016)... TX (PRWEB) , ... December 07, 2016 , ... ... 2016 Top 20 Marketing Campaign Winner in the Folio: Marketing Awards competition. Live ... recognize the year’s best in pioneering, inventive, and ultimately successful projects undertaken by ...
(Date:12/7/2016)... ... December 07, 2016 , ... ... (IFW) Program at Reproductive Medicine Associates of Connecticut (RMACT). McLaughlin brings nearly 20 ... of three acupuncturists to help patients realize their family building goals. Acupuncture ...
Breaking Medicine News(10 mins):
(Date:12/7/2016)... , Dec. 7,2016  Based on ... delivery industry, Frost & Sullivan recognizes Nemaura ... & Sullivan Award for Enabling Technology Leadership. ... the loopholes in traditional drug delivery technologies, ... liquid microneedle-based drug delivery technologies, Memspatch and ...
(Date:12/7/2016)... , December 7, 2016 According ... Research titled , Global Market Study on Multiplex Detection Immunoassay: ... , the global multiplex detection immunoassay market is expected to ... 2016-2024. ... ,      ...
(Date:12/6/2016)... Mass. , Dec. 6, 2016  Alopexx Oncology, ... DI-Leu16-IL2, a recombinant antibody fusion protein (immunocytokine) composed of ... recognizes the same target on B cells as Rituxan ... cytokine components but is also involved in tumor targeting, ... anti-cancer vaccine effect. The results of the study (abstract ...
Breaking Medicine Technology: