Transanal hemorrhoidal dearterialization (THD) versus stapled hemorrhoidopexy (SH) in treatment of internal hemorrhoids: a systematic review and meta-analysis of randomized clinical trials

被引:30
|
作者
Emile, Sameh Hany [1 ]
Elfeki, Hossam [1 ,2 ]
Sakr, Ahmad [1 ,3 ]
Shalaby, Mostafa [1 ]
机构
[1] Mansoura Univ Hosp, Mansoura Fac Med, Colorectal Surg Unit, Dept Gen Surg, Elgomhuoria St, Mansoura, Egypt
[2] Aarhus Univ Hosp, Dept Surg, Aarhus, Denmark
[3] Yonsei Univ, Coll Med, Colorectal Surg Dept, Seoul, South Korea
关键词
Transanal hemorrhoidal dearterialization; Stapled hemorrhoidopexy; Hemorrhoids; Meta-analysis; Randomized clinical trials; MILLIGAN-MORGAN; FOLLOW-UP; HAEMORRHOIDOPEXY; MULTICENTER; PPH; COMPLICATIONS; RETENTION; ANOPEXY; PAIN;
D O I
10.1007/s00384-018-3187-3
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
BackgroundAlthough conventional hemorrhoidectomy proved effective in treatment of hemorrhoidal disease, postoperative pain remains a vexing problem. Alternatives to conventional hemorrhoidectomy as transanal hemorrhoidal dearterialization (THD) and stapled hemorrhoidopexy (SH) were described. The present meta-analysis aimed to review the randomized trials that compared THD and SH to determine which technique is superior in terms of recurrence of hemorrhoids, complications, and postoperative pain.MethodsElectronic databases were searched for randomized trials that compared THD and SH for internal hemorrhoids. The PRISMA guidelines were followed when reporting this meta-analysis. The primary endpoint of the analysis was persistence or recurrence of hemorrhoidal disease. Secondary endpoints were postoperative pain, complications, readmission, return to work, and patients' satisfaction.ResultsSix randomized trials including 554 patients (THD=280; SH=274) were included. The mean postoperative pain score of THD was significantly lower than SH (2.91.5 versus 3.3 +/- 1.6). 13.2% of patients experienced persistent or recurrent hemorrhoids after THD versus 6.9% after SH (OR=1.93, 95%CI=1.07-3.51, p=0.029). Complications were recorded in 17.1% of patients who underwent THD and 23.3% of patients who underwent SH (OR=0.68, 95%CI 0.43-1.05, p=0.08). The average duration to return to work after THD was 7.3 +/- 5.2 versus 7.7 +/- 4.8days after SH (p=0.34). Grade IV hemorrhoids was significantly associated with persistence or recurrence of hemorrhoidal disease after both procedures.Conclusion THD had significantly higher persistence/recurrence rate compared to SH whereas complication and readmission rates, hospital stay, return to work, and patients' satisfaction were similar in both groups.
引用
收藏
页码:1 / 11
页数:11
相关论文
共 50 条
  • [1] Transanal hemorrhoidal dearterialization (THD) versus stapled hemorrhoidopexy (SH) in treatment of internal hemorrhoids: a systematic review and meta-analysis of randomized clinical trials
    Sameh Hany Emile
    Hossam Elfeki
    Ahmad Sakr
    Mostafa Shalaby
    [J]. International Journal of Colorectal Disease, 2019, 34 : 1 - 11
  • [2] Transanal hemorrhoidal dearterialization versus stapled hemorrhoidectomy in the treatment of hemorrhoids: an update meta-analysis of randomized control trials
    Yao, Qi
    Chen, Honglei
    Wan, Xingyang
    He, Lanzhen
    Liu, Yanan
    [J]. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE, 2018, 11 (11): : 11940 - 11948
  • [3] Stapled Hemorrhoidectomy Versus Transanal Hemorrhoidal Dearterialization in the Treatment of Hemorrhoids: An Updated Meta-Analysis
    Xu, Li
    Chen, Honglei
    Gu, Yunfei
    [J]. SURGICAL LAPAROSCOPY ENDOSCOPY & PERCUTANEOUS TECHNIQUES, 2019, 29 (02): : 75 - 81
  • [4] Transanal hemorrhoidal dearterialization versus stapled hemorrhoidectomy in the treatment of hemorrhoids A PRISMA-compliant updated meta-analysis of randomized control trials
    Song, Yan
    Chen, Honglei
    Yang, Fang
    Zeng, Yuheng
    He, Yongheng
    Huang, Huiyong
    [J]. MEDICINE, 2018, 97 (29)
  • [5] Transanal hemorrhoidal dearterialization with mucopexy versus open hemorrhoidectomy in the treatment of hemorrhoids: a meta-analysis of randomized control trials
    L. Xu
    H. Chen
    G. Lin
    Q. Ge
    H. Qi
    X. He
    [J]. Techniques in Coloproctology, 2016, 20 : 825 - 833
  • [6] Transanal hemorrhoidal dearterialization with mucopexy versus open hemorrhoidectomy in the treatment of hemorrhoids: a meta-analysis of randomized control trials
    Xu, L.
    Chen, H.
    Lin, G.
    Ge, Q.
    Qi, H.
    He, X.
    [J]. TECHNIQUES IN COLOPROCTOLOGY, 2016, 20 (12) : 825 - 833
  • [7] Prospective non-randomized trial of transanal hemorrhoidal dearterialization versus stapled hemorrhoidopexy
    Giordano, P.
    Nastro, P.
    Ahmed, S.
    [J]. DISEASES OF THE COLON & RECTUM, 2007, 50 (05) : 742 - 742
  • [8] Stapled Hemorrhoidectomy Versus Transanal Hemorrhoidal Dearterialization in the Treatment of Hemorrhoids: An Updated Meta-analysis (vol 29, pg 75, 2019)
    Chen, Honglei
    [J]. SURGICAL LAPAROSCOPY ENDOSCOPY & PERCUTANEOUS TECHNIQUES, 2019, 29 (05): : 416 - 416
  • [9] Systematic Review and Meta Analysis: Transanal Hemorrhoidal Dearterialization (THD) versus Milligan-Morgan Hemorrhoidectomy (MMH) in Grade III/IV Hemorrhoids
    Kazemi, N.
    Mena, J.
    Elzeftawy, M.
    [J]. BRITISH JOURNAL OF SURGERY, 2024, 111
  • [10] Doppler-Guided Transanal Hemorrhoidal Dearterialization (DG-THD) Versus Stapled Hemorrhoidopexy (SH) in the Treatment of Third-Degree Hemorrhoids: Clinical Results at Short and Long-Term Follow-Up
    S. Leardi
    B. Pessia
    M. Mascio
    F. Piccione
    M. Schietroma
    R. Pietroletti
    [J]. Journal of Gastrointestinal Surgery, 2016, 20 : 1886 - 1890