Randomized clinical trial of stapled haemorrhoidopexy versus conventional diathermy haemorrhoidectomy.
BACKGROUND
The aim of this study was to compare the results of stapled haemorrhoidopexy (commonly called stapled haemorrhoidectomy) with those of conventional diathermy haemorrhoidectomy.


METHODS
Fifty-five patients with symptomatic third- and fourth-degree haemorrhoids were randomized to either stapled haemorrhoidopexy (n = 27) or conventional diathermy haemorrhoid ectomy (n = 28). Operating time, postoperative pain, time to return to work, postoperative complications and effectiveness of haemorrhoidal symptom control were recorded. The mean follow-up was 15.9 months in the stapled haemorrhoidopexy group and 15.2 months in the conventional haemorrhoidectomy group.


RESULTS
Mean pain intensity was significantly less in the stapled group (P = 0.001). There were no significant differences in the total number of complications, the length of absence from work or control of symptoms. Seven patients in the stapled group re-presented with prolapse compared with none in the conventional haemorrhoidectomy group (P = 0.004). This difference was also observed in the subset of patients with fourth-degree haemorrhoids (P = 0.003).


CONCLUSIONS
The stapled operation was significantly less painful than conventional haemorrhoidectomy. However, the rate of recurrent prolapse was higher after stapled haemorrhoidopexy than after conventional diathermy haemorrhoidectomy.
Ortiz
H
H
Unit of Coloproctology, Department of Surgery, Hospital Virgen del Camino, Irunlarrea 4, E-31008 Pamplona, Navarra, Spain. HHORTIZ@teleline.es
Marzo
J
J
Armendariz
P
P
D003972:Diathermy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006484:Hemorrhoids / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology*; D012005:Rectal Prolapse / Q000209:etiology / Q000601:surgery; D012008:Recurrence; D017792:Surgical Stapling / Q000379:methods*; D016896:Treatment Outcome