Dr Shanmugam and colleagues reviewed 2 treatments for hemorrhoids, namely rubber band ligation and excisional hemorrhoidectomy.
The investigators identified randomized trials from the major electronic databases.
Symptom control, retreatment, postoperative pain, complications, time off work and patient satisfaction were assessed.
Relative risk and weighted mean difference with 95 per cent confidence interval were estimated.
The investigative team used a random-effects model for dichotomous and continuous outcomes, respectively.
|Complete remission of hemorrhoidal symptoms was better after hemorrhoidectomy|
|British Journal of Surgery|
The team found 3 trials that met the inclusion criteria, and all were of poor methodological quality.
Complete remission of hemorrhoidal symptoms was better after hemorrhoidectomy.
The investigators observed that there was significant heterogeneity between the studies.
Fewer patients required retreatment after hemorrhoidectomy.
The team noted, however, that anal stenosis, postoperative hemorrhage and incontinence to flatus were more common with this operation.
Dr Shanmuga's team concluded, “Hemorrhoidectomy produced better long-term symptom control in patients with grade III hemorrhoids.”
“This was associated with more postoperative complications than rubber band ligation.”