Procedure for prolapsed haemorrhoids versus Excisional Haemorrhoidectomy - A Systematic Review and Meta-Analysis

Abstract

Objective: To assess the efficacy of Procedure for prolapsed haemorrhoids versus excisional haemorrhoidectomy to treat haemorrhoids.

Study Design: Randomised controlled trials comparing EH and PPH with >15 patients.

Place and Duration of Study:  This study was conducted at Nishtar Medical College, Multan from December 2011 to May 2012.

Materials and Methods: All articles addressing haemorrhoidectomy were identified using the Medline and Pubmed Web sites with the period of review extending from December 2011 to May 2012. Articles addressing PPH and EH were then reviewed. The search included in English language. All randomised controlled comparative trials and patient samples of >15 patients were considered for the meta-analysis. The primary endpoints assessed were pain and time taken to return to normal activity. Secondary endpoints were bleeding, complications and residual symptoms, recurrence rates and re-interventions

Results: PPH was associated with less postoperative pain, earlier return to normal activities compared with EH.  There was no difference between the two procedures in terms of complications. There were more recurrences after PPH.
Conclusion: Compared with EH, PPH is associated with less postoperative pain, earlier return to normal activity. The rate of recurrence appears higher with PPH.