Stapled haemorrhoidopexy for the treatment of haemorrhoids: a systematic review

被引:60
作者
Burch, J. [1 ]
Epstein, D. [3 ]
Baba-Akbari Sari, A. [1 ]
Weatherly, H. [3 ]
Jayne, D. [2 ]
Fox, D. [1 ]
Woolacott, N. [1 ]
机构
[1] Univ York, CRD, York YO10 5DD, N Yorkshire, England
[2] St James Univ Hosp, Leeds, W Yorkshire, England
[3] Univ York, Ctr Hlth Econ, York YO10 5DD, N Yorkshire, England
关键词
Haemorrhoidectomy; PPH; circular stapler; Milligan-Morgan; Ferguson; RANDOMIZED CONTROLLED-TRIAL; MILLIGAN-MORGAN HEMORRHOIDECTOMY; CLINICAL-TRIAL; CLOSED HEMORRHOIDECTOMY; DIATHERMY HEMORRHOIDECTOMY; EXCISION HEMORRHOIDECTOMY; MULTICENTER TRIAL; ANOPEXY; MUCOSECTOMY; RESECTION;
D O I
10.1111/j.1463-1318.2008.01638.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
This systematic review aimed to evaluate the short- and long-term safety, efficacy and costs of stapled haemorrhoidopexy (SH) compared with conventional haemorrhoidectomy. 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. 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. 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.
引用
收藏
页码:233 / 243
页数:11
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