title: Meta-analysis of randomized controlled trials comparing outcomes for stapled hemorrhoidopexy versus LigaSure hemorrhoidectomy for symptomatic hemorrhoids in adults.
abstract: This purpose of the meta-analysis was to compare treatment outcomes for adult patients with symptomatic hemorrhoids treated by stapled hemorrhoidopexy or LigaSure hemorrhoidectomy. A search of public medical databases was made to identify randomized controlled trials (RCTs) comparing stapled hemorrhoidopexy (SH) with LigaSure hemorrhoidectomy (LH) for the treatment of adult patients with symptomatic grade 3 and grade 4 hemorrhoids. Postoperative pain as measured using a visual analog scale was the primary outcome, and rate of recurrent prolapse and postoperative bleeding were secondary outcome measures. Four RCTs were identified that met the inclusion criteria. Data for the pooled outcomes were analyzed using odds ratio (OR) analysis. None of the studies in the analysis indicated a significant difference between SH and LH for the outcomes VAS pain score, recurrence rate, or postoperative bleeding. Pooled analysis revealed a significant OR in favor of the SH method for recurrent prolapse (OR = 5.529, P = 0.016) for up to 2 years after surgery. No significant differences between the two methods were identified for VAS pain scores (OR = -1.060, P = 0.149) or postoperative bleeding OR = 1.188, P = 0.871). Pooled analysis of RCT results comparing SH to LH for symptomatic hemorrhoids revealed a significantly greater incidence of recurrent prolapse for SH. The two techniques were associated with similar levels of postoperative pain and postoperative bleeding.
authors.affiliation: Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital - Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Ko-Chao
authors.initials: KC
authors.lastname: Lee
authors.forename: Hong-Hwa
authors.initials: HH
authors.lastname: Chen
authors.forename: Kuan-Chih
authors.initials: KC
authors.lastname: Chung
authors.forename: Wan-Hsiang
authors.initials: WH
authors.lastname: Hu
authors.forename: Chia-Lo
authors.initials: CL
authors.lastname: Chang
authors.forename: Shung-Eing
authors.initials: SE
authors.lastname: Lin
authors.forename: Kai-Lung
authors.initials: KL
authors.lastname: Tsai
authors.forename: Chien-Chang
authors.initials: CC
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D061865:Hemorrhoidectomy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D019106:Postoperative Hemorrhage / Q000209:etiology; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D064232:Visual Analog Scale; D055815:Young Adult
keywords: Hemorrhoids; LigaSure hemorrhoidectomy; Meta-analysis; Recurrence; Stapled hemorrhoidopexy