Skip to main content
Erschienen in: International Journal of Colorectal Disease 3/2009

01.03.2009 | Original Article

Stapled haemorrhoidopexy compared to Milligan–Morgan and Ferguson haemorrhoidectomy: a systematic review

verfasst von: K. Laughlan, D. G. Jayne, D. Jackson, F. Rupprecht, G. Ribaric

Erschienen in: International Journal of Colorectal Disease | Ausgabe 3/2009

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The aim of this study was to perform a systematic review and meta-analysis of the short- and long-term outcomes of stapled haemorrhoidopexy.

Methods

A literature search identified randomised controlled trials comparing stapled haemorrhoidopexy with Milligan–Morgan/Ferguson haemorrhoidectomy. Data were extracted independently for each study and differences analysed with fixed and random effects models.

Results

Thirty-four randomised trials and two systematic reviews were identified, and 29 trials included. Stapled haemorrhoidopexy was statistically superior for hospital stay (p < 0.001) and numerically superior for post-operative pain (peri-operative and mid-term), operation time and bleeding (post-operative and long-term). Recurrent prolapse and re-intervention for recurrence were more frequent following stapled haemorrhoidopexy. No difference was observed in the rates of complications.

Conclusions

Stapled haemorrhoidopexy reduces the length of hospital stay and may have an advantage in terms of decreased operating time, reduced post-operative pain and less bleeding but is associated with an increased rate of recurrent prolapse.
Literatur
1.
Zurück zum Zitat Hardy A, Chan CLH, Cochen CRG (2005) The surgical management of haemorrhoids—review. Dig Surg 22:26–33PubMedCrossRef Hardy A, Chan CLH, Cochen CRG (2005) The surgical management of haemorrhoids—review. Dig Surg 22:26–33PubMedCrossRef
2.
Zurück zum Zitat Loder PB, Kamm MA, Nichollsa RJ, Philips RKS (1994) Haemorrhoids: pathology, pathophysiology and etiology. Br J Surg 81:946–954PubMedCrossRef Loder PB, Kamm MA, Nichollsa RJ, Philips RKS (1994) Haemorrhoids: pathology, pathophysiology and etiology. Br J Surg 81:946–954PubMedCrossRef
3.
Zurück zum Zitat Johannsson HO, Graf W, Pahlman L (2002) Long term results of hemorrhoidectomy. Eur J Surg 168:485–489PubMedCrossRef Johannsson HO, Graf W, Pahlman L (2002) Long term results of hemorrhoidectomy. Eur J Surg 168:485–489PubMedCrossRef
4.
Zurück zum Zitat Haas PA, Fox TA Jr, Haas GP (1984) The pathogenesis of haemorrhoids. Dis Colon Rectum 27:442–450PubMedCrossRef Haas PA, Fox TA Jr, Haas GP (1984) The pathogenesis of haemorrhoids. Dis Colon Rectum 27:442–450PubMedCrossRef
5.
Zurück zum Zitat Khalil KH, O’Bichere A, Sellu D (2000) Randomized clinical trial of sutured versus stapled closed haemorrhoidectomy. Br J Surg 87:1352–1355PubMedCrossRef Khalil KH, O’Bichere A, Sellu D (2000) Randomized clinical trial of sutured versus stapled closed haemorrhoidectomy. Br J Surg 87:1352–1355PubMedCrossRef
6.
Zurück zum Zitat Andrews BT, Layer GT, Jackson BT, Nicholls RJ (1993) Randomized trial comparing diathermy hemorrhoidectomy with the scissor dissection Milligan–Morgan operation. Dis Colon Rectum 36:580–583PubMedCrossRef Andrews BT, Layer GT, Jackson BT, Nicholls RJ (1993) Randomized trial comparing diathermy hemorrhoidectomy with the scissor dissection Milligan–Morgan operation. Dis Colon Rectum 36:580–583PubMedCrossRef
7.
Zurück zum Zitat Wang JY, Chang Chien CR, Chen JS, Lai CR, Tang R (1991) The role of lasers in haemorrhoidectomy. Dis Colon Rectum 34:78–82PubMedCrossRef Wang JY, Chang Chien CR, Chen JS, Lai CR, Tang R (1991) The role of lasers in haemorrhoidectomy. Dis Colon Rectum 34:78–82PubMedCrossRef
8.
Zurück zum Zitat Jayne DG, Botterill I, Ambrose NS, Brennan TG, Guillou OJ, O’Riodain DS (2002) Randomised clinical trial of ligasure versus conventional diathermy for day case haemorrhoidectomy. Br J Surg 89:428–432PubMedCrossRef Jayne DG, Botterill I, Ambrose NS, Brennan TG, Guillou OJ, O’Riodain DS (2002) Randomised clinical trial of ligasure versus conventional diathermy for day case haemorrhoidectomy. Br J Surg 89:428–432PubMedCrossRef
9.
Zurück zum Zitat Tan JJ, Seow-Choen F (2001) Prospective randomised trial comparing diathermy and Harmonic Scalpel haemorrhoidectomy. Dis Colon Rectum 44:677–679PubMedCrossRef Tan JJ, Seow-Choen F (2001) Prospective randomised trial comparing diathermy and Harmonic Scalpel haemorrhoidectomy. Dis Colon Rectum 44:677–679PubMedCrossRef
10.
Zurück zum Zitat Milligan E, Morgan C, Jones L, Officer R (1937) Surgical anatomy of the anal canal, and operative treatment of haemorrhoids. Lancet ii:1129–1124 Milligan E, Morgan C, Jones L, Officer R (1937) Surgical anatomy of the anal canal, and operative treatment of haemorrhoids. Lancet ii:1129–1124
11.
12.
Zurück zum Zitat Justin TA, Armitage NC (1999) Haemorrhoidectomy: 5 years later. Br J Surg 86:60, (Abstr) Justin TA, Armitage NC (1999) Haemorrhoidectomy: 5 years later. Br J Surg 86:60, (Abstr)
13.
Zurück zum Zitat Longo A (1998) Treatment of haemorrhoid disease by reduction in mucosal and haemorrhoidal products with a circular stapling device—new procedure. Proceedings of the 6th World Congress of Endoscopic Surgery, Rome, Italy Longo A (1998) Treatment of haemorrhoid disease by reduction in mucosal and haemorrhoidal products with a circular stapling device—new procedure. Proceedings of the 6th World Congress of Endoscopic Surgery, Rome, Italy
14.
Zurück zum Zitat Corman ML, Gravie JF, Hager T, Loudon MA, Mascagni D, Nystrom PO et al (2003) Stapled haemorrhoidopexy: a consensus position paper by an international working party—indications, contraindications and technique. Colorectal Dis 5:304–310PubMedCrossRef Corman ML, Gravie JF, Hager T, Loudon MA, Mascagni D, Nystrom PO et al (2003) Stapled haemorrhoidopexy: a consensus position paper by an international working party—indications, contraindications and technique. Colorectal Dis 5:304–310PubMedCrossRef
15.
Zurück zum Zitat Au-Yong I, Rowsell M, Hemingway DM (2004) Randomised controlled clinical trial of stapled haemorrhoidectomy vs conventional haemorrhoidectomy; a three and a half year follow up. Colorectal Dis 6:37–38PubMedCrossRef Au-Yong I, Rowsell M, Hemingway DM (2004) Randomised controlled clinical trial of stapled haemorrhoidectomy vs conventional haemorrhoidectomy; a three and a half year follow up. Colorectal Dis 6:37–38PubMedCrossRef
16.
Zurück zum Zitat Ganio E, Altomare DF, Gabrielli F, Milito G, Canuti S (2001) Prospective randomized multicentre trial comparing stapled with open haemorrhoidectomy. Br J Surg 88:669–674PubMedCrossRef Ganio E, Altomare DF, Gabrielli F, Milito G, Canuti S (2001) Prospective randomized multicentre trial comparing stapled with open haemorrhoidectomy. Br J Surg 88:669–674PubMedCrossRef
17.
Zurück zum Zitat Mehigan BJ, Monson JR, Hartley JE (2000) Stapling procedure for haemorrhoids versus Milligan–Morgan haemorrhoidectomy: randomised controlled trial. Lancet 355:782–785PubMedCrossRef Mehigan BJ, Monson JR, Hartley JE (2000) Stapling procedure for haemorrhoids versus Milligan–Morgan haemorrhoidectomy: randomised controlled trial. Lancet 355:782–785PubMedCrossRef
18.
Zurück zum Zitat Rowsell M, Bello M, Hemingway DM (2000) Circumferential mucosectomy (stapled haemorrhoidectomy) versus conventional haemorrhoidectomy: randomised controlled trial. Lancet 355:779–781PubMedCrossRef Rowsell M, Bello M, Hemingway DM (2000) Circumferential mucosectomy (stapled haemorrhoidectomy) versus conventional haemorrhoidectomy: randomised controlled trial. Lancet 355:779–781PubMedCrossRef
19.
Zurück zum Zitat Schalaby R, Desoky A (2001) Randomized clinical trial of stapled versus Milligan–Morgan haemorrhoidectomy. Br J Surg 88:1049–1053CrossRef Schalaby R, Desoky A (2001) Randomized clinical trial of stapled versus Milligan–Morgan haemorrhoidectomy. Br J Surg 88:1049–1053CrossRef
21.
Zurück zum Zitat Basdanis G, Papdopoulos VN, Michalopoulos A, Apostolidis S, Harlaftis N (2005) Randomized clinical trial of stapled hemorrhoidectomy vs open with Ligasure for prolapsed piles. Surg Endosc 19:235–239PubMedCrossRef Basdanis G, Papdopoulos VN, Michalopoulos A, Apostolidis S, Harlaftis N (2005) Randomized clinical trial of stapled hemorrhoidectomy vs open with Ligasure for prolapsed piles. Surg Endosc 19:235–239PubMedCrossRef
22.
Zurück zum Zitat Bickhandani J, Agarwal PN, Kant R, Malik VK (2005) Randomized controlled trial to compare the early and mid-term results of stapled versus open hemorrhoidectomy. Am J Surg 189:56–60CrossRef Bickhandani J, Agarwal PN, Kant R, Malik VK (2005) Randomized controlled trial to compare the early and mid-term results of stapled versus open hemorrhoidectomy. Am J Surg 189:56–60CrossRef
23.
Zurück zum Zitat Brown SR, Ballan K, Ho E, Ho Fams YH, Seow-Choen F (2001) Stapled mucosectomy for acute thrombosed circumferentially prolapsed piles: a prospective randomized comparison with conventional haemorrhoidectomy. Colorectal Dis 3:175–178PubMedCrossRef Brown SR, Ballan K, Ho E, Ho Fams YH, Seow-Choen F (2001) Stapled mucosectomy for acute thrombosed circumferentially prolapsed piles: a prospective randomized comparison with conventional haemorrhoidectomy. Colorectal Dis 3:175–178PubMedCrossRef
24.
Zurück zum Zitat Cheetham MJ, Cohen CR, Kamm MA, Phillips RK (2003) A randomized, controlled trial of diathermy hemorrhoidectomy vs. stapled hemorrhoidectomy in an intended day-care setting with longer-term follow-up. Dis Colon Rectum 46:491–497PubMedCrossRef Cheetham MJ, Cohen CR, Kamm MA, Phillips RK (2003) A randomized, controlled trial of diathermy hemorrhoidectomy vs. stapled hemorrhoidectomy in an intended day-care setting with longer-term follow-up. Dis Colon Rectum 46:491–497PubMedCrossRef
25.
Zurück zum Zitat Chung CC, Cheung HYS, Chan ESW, Kwok SY, Li MKW (2005) Stapled hemorrhoidopexy vs Harmonic Scalpel hemorrhoidectomy: a randomized trial. Dis Colon Rectum 48:1213–1219PubMedCrossRef Chung CC, Cheung HYS, Chan ESW, Kwok SY, Li MKW (2005) Stapled hemorrhoidopexy vs Harmonic Scalpel hemorrhoidectomy: a randomized trial. Dis Colon Rectum 48:1213–1219PubMedCrossRef
26.
Zurück zum Zitat Correa-Rovelo JM, Tellez O, Obregon L, Miranda-Gomez A, Moran S (2002) Stapled rectal mucosectomy vs. closed hemorrhoidectomy: a randomized, clinical trial. Dis Colon Rectum 45:1367–1374PubMedCrossRef Correa-Rovelo JM, Tellez O, Obregon L, Miranda-Gomez A, Moran S (2002) Stapled rectal mucosectomy vs. closed hemorrhoidectomy: a randomized, clinical trial. Dis Colon Rectum 45:1367–1374PubMedCrossRef
27.
Zurück zum Zitat Gravie JF, Lehur P-A, Huten N, Papillon M, Fantoli M, Descottes B, Pessaux P, Arnaud JP (2005) Stapled hemorrhoidopexy versus Milligan–Morgan hemorrhoidectomy. A prospective, randomized, multicenter trial with 2-year postoperative follow up. Ann Surg 242:29–35PubMedCrossRef Gravie JF, Lehur P-A, Huten N, Papillon M, Fantoli M, Descottes B, Pessaux P, Arnaud JP (2005) Stapled hemorrhoidopexy versus Milligan–Morgan hemorrhoidectomy. A prospective, randomized, multicenter trial with 2-year postoperative follow up. Ann Surg 242:29–35PubMedCrossRef
28.
Zurück zum Zitat Hetzer FH, Demartines N, Handschin AE, Clavien PA (2002) Stapled vs excision hemorrhoidectomy: long-term results of a prospective randomized trial. Arch Surg 137:337–340PubMedCrossRef Hetzer FH, Demartines N, Handschin AE, Clavien PA (2002) Stapled vs excision hemorrhoidectomy: long-term results of a prospective randomized trial. Arch Surg 137:337–340PubMedCrossRef
29.
Zurück zum Zitat Kairaluoma M, Nuorva K, Kellokumpu I (2003) Daycase stapled (circular) vs. diathermy hemorrhoidectomy. A randomized, controlled trial evaluating surgical and functional outcome. Dis Colon Rectum 46:93–99PubMedCrossRef Kairaluoma M, Nuorva K, Kellokumpu I (2003) Daycase stapled (circular) vs. diathermy hemorrhoidectomy. A randomized, controlled trial evaluating surgical and functional outcome. Dis Colon Rectum 46:93–99PubMedCrossRef
30.
Zurück zum Zitat Kraemer M, Parulava T, Roblick M, Duschka L, Müller-Lobeck H (2005) Prospective, randomized study: proximate PPH stapler vs. Ligasure for hemorrhoidal surgery. Dis Colon Rectum 48:1517–1522PubMedCrossRef Kraemer M, Parulava T, Roblick M, Duschka L, Müller-Lobeck H (2005) Prospective, randomized study: proximate PPH stapler vs. Ligasure for hemorrhoidal surgery. Dis Colon Rectum 48:1517–1522PubMedCrossRef
31.
Zurück zum Zitat Krska Z, Kvasnieka J, Faltyn J, Schmidt D, Svab J, Kormanova K, Hubik J (2005) Surgical treatment of haemorrhoids according to Longo and Milligan Morgan: an evaluation of postoperative tissue response. Colorectal Dis 5:573–576CrossRef Krska Z, Kvasnieka J, Faltyn J, Schmidt D, Svab J, Kormanova K, Hubik J (2005) Surgical treatment of haemorrhoids according to Longo and Milligan Morgan: an evaluation of postoperative tissue response. Colorectal Dis 5:573–576CrossRef
32.
Zurück zum Zitat Lau PYY, Meng WCS, Yip AWC (2004) Stapled haemorrhoidectomy in Chinese patients: a prospective randomized control study. Hong Kong Med J 20:373–377 Lau PYY, Meng WCS, Yip AWC (2004) Stapled haemorrhoidectomy in Chinese patients: a prospective randomized control study. Hong Kong Med J 20:373–377
33.
Zurück zum Zitat Maw A, Concepcion Eu KW, Seow-Choen F, Heah SM, Tang CL, Tan AL (2003) Prospective randomized study of bacteraemia in diathermy and stapled haemorrhoidectomy. Br J Surg 90:222–226PubMedCrossRef Maw A, Concepcion Eu KW, Seow-Choen F, Heah SM, Tang CL, Tan AL (2003) Prospective randomized study of bacteraemia in diathermy and stapled haemorrhoidectomy. Br J Surg 90:222–226PubMedCrossRef
34.
Zurück zum Zitat Ortiz H, Marzo J, Armendariz P (2002) Randomized clinical trial of stapled haemorrhoidopexy versus conventional diathermy haemorrhoidectomy. Br J Surg 89:1376–1381PubMedCrossRef Ortiz H, Marzo J, Armendariz P (2002) Randomized clinical trial of stapled haemorrhoidopexy versus conventional diathermy haemorrhoidectomy. Br J Surg 89:1376–1381PubMedCrossRef
35.
Zurück zum Zitat Ortiz H, Marzo J, Armendariz P, De Miguel M (2005) Stapled hemorrhoidopexy vs. diathermy excision for fourth-degree hemorrhoids: a randomized, clinical trial and review of the literature. Dis Colon Rectum 48:809–815PubMedCrossRef Ortiz H, Marzo J, Armendariz P, De Miguel M (2005) Stapled hemorrhoidopexy vs. diathermy excision for fourth-degree hemorrhoids: a randomized, clinical trial and review of the literature. Dis Colon Rectum 48:809–815PubMedCrossRef
36.
Zurück zum Zitat Palimento D, Picchio M, Attanasio U, Lombardi A, Bambini C, Renda A (2003) Stapled and open hemorrhoidectomy: randomized controlled trial of early results. World J Surg 27:203–207PubMed Palimento D, Picchio M, Attanasio U, Lombardi A, Bambini C, Renda A (2003) Stapled and open hemorrhoidectomy: randomized controlled trial of early results. World J Surg 27:203–207PubMed
37.
Zurück zum Zitat Pavlidis T, Papaziogas B, Souparis A, Patsas A, Koutelidakis I, Papaziogas T (2002) Modern stapled Longo procedure vs. conventional Milligan–Morgan hemorrhoidectomy: a randomized controlled trial. Int J Colorectal Dis 17:50–53PubMedCrossRef Pavlidis T, Papaziogas B, Souparis A, Patsas A, Koutelidakis I, Papaziogas T (2002) Modern stapled Longo procedure vs. conventional Milligan–Morgan hemorrhoidectomy: a randomized controlled trial. Int J Colorectal Dis 17:50–53PubMedCrossRef
38.
Zurück zum Zitat Picchio M, Palimento D, Attanasio U, Renda A (2006) Stapled vs open hemorrhoidectomy: long-term outcome of a randomized controlled trial. Int J Colorectal Dis 21:668–669PubMedCrossRef Picchio M, Palimento D, Attanasio U, Renda A (2006) Stapled vs open hemorrhoidectomy: long-term outcome of a randomized controlled trial. Int J Colorectal Dis 21:668–669PubMedCrossRef
39.
Zurück zum Zitat Racabulto A, Aliotta I, Corsaro G, Lanteri R, Di Cataldo A, Licata A (2004) Hemorrhoidal stapler prolapsectomy vs. Milligan–Morgan hemorrhoidectomy: a long-term randomized trial. Int J Colorectal Dis 19:239–244CrossRef Racabulto A, Aliotta I, Corsaro G, Lanteri R, Di Cataldo A, Licata A (2004) Hemorrhoidal stapler prolapsectomy vs. Milligan–Morgan hemorrhoidectomy: a long-term randomized trial. Int J Colorectal Dis 19:239–244CrossRef
40.
Zurück zum Zitat Senagore AJ, Singer MS, Abcarian H, Fleshman J, Corman M, Wexner S, Nivatvongs S (2004) A prospective, randomized, controlled multicenter trail comparing stapled hemorrhoidopexy and Ferguson hemorrhoidectomy: perioperative and one-year results. Dis Colon Rectum 47:1824–1836PubMedCrossRef Senagore AJ, Singer MS, Abcarian H, Fleshman J, Corman M, Wexner S, Nivatvongs S (2004) A prospective, randomized, controlled multicenter trail comparing stapled hemorrhoidopexy and Ferguson hemorrhoidectomy: perioperative and one-year results. Dis Colon Rectum 47:1824–1836PubMedCrossRef
41.
Zurück zum Zitat Smyth EF, Baker RP, Wilken BJ, Hartley JE, White T, Monson JRT (2003) Stapled versus excision haemorrhoidectomy: long term follow up of a randomized controlled trial. Lancet 361:1437–1438PubMedCrossRef Smyth EF, Baker RP, Wilken BJ, Hartley JE, White T, Monson JRT (2003) Stapled versus excision haemorrhoidectomy: long term follow up of a randomized controlled trial. Lancet 361:1437–1438PubMedCrossRef
42.
Zurück zum Zitat Stadt van de J, D’Hoore A, Duinslaeger M, Chasse E, Pennickx F (2005) Long-term results after excision haemorrhoidectomy versus stapled haemorrhoidopexy for prolapsing haemorrhoids. A Belgian prospective randomized trial. Acta Chir Belg 105:44–52 Stadt van de J, D’Hoore A, Duinslaeger M, Chasse E, Pennickx F (2005) Long-term results after excision haemorrhoidectomy versus stapled haemorrhoidopexy for prolapsing haemorrhoids. A Belgian prospective randomized trial. Acta Chir Belg 105:44–52
43.
Zurück zum Zitat Wilson MS, Pope V, Doran HE, Fearn SJ, Brough WA (2002) Objective comparison of stapled anopexy and open hemorrhoidectomy. Dis Colon Rectum 45:1437–1438PubMedCrossRef Wilson MS, Pope V, Doran HE, Fearn SJ, Brough WA (2002) Objective comparison of stapled anopexy and open hemorrhoidectomy. Dis Colon Rectum 45:1437–1438PubMedCrossRef
44.
Zurück zum Zitat Ho YH, Cheong WK, Tsang C, Ho J, Eu KW, Tang CL, Seow-Choen F (2000) Stapled hemorrhoidectomy—cost and effectiveness. Randomized, controlled trial including incontinence scoring, anorectal manometry, and endoanal ultrasound assessments at up to three months. Dis Colon Rectum 43:1666–1675PubMedCrossRef Ho YH, Cheong WK, Tsang C, Ho J, Eu KW, Tang CL, Seow-Choen F (2000) Stapled hemorrhoidectomy—cost and effectiveness. Randomized, controlled trial including incontinence scoring, anorectal manometry, and endoanal ultrasound assessments at up to three months. Dis Colon Rectum 43:1666–1675PubMedCrossRef
45.
Zurück zum Zitat Kirsch JJ, Staude G, Herold A (2001) Hämorrhoidektomien nach Longo und Milligan–Morgan. Prospektive Vergleichstudie mit 300 Patienten. Chirurg 72:180–185PubMedCrossRef Kirsch JJ, Staude G, Herold A (2001) Hämorrhoidektomien nach Longo und Milligan–Morgan. Prospektive Vergleichstudie mit 300 Patienten. Chirurg 72:180–185PubMedCrossRef
46.
Zurück zum Zitat Boccasanta P, Capretti P, Venturi M, Cioffi U, De Simone M, Salamina G et al (2001) Randomised controlled trial between stapled circumferential mucosectomy and conventional circular hemorrhoidectomy in advanced hemorrhoids with external mucosal prolapse. Am J Surg 182:64–68PubMedCrossRef Boccasanta P, Capretti P, Venturi M, Cioffi U, De Simone M, Salamina G et al (2001) Randomised controlled trial between stapled circumferential mucosectomy and conventional circular hemorrhoidectomy in advanced hemorrhoids with external mucosal prolapse. Am J Surg 182:64–68PubMedCrossRef
47.
Zurück zum Zitat Hasse C, Sitter H, Brune M, Wollenteit I, Lorenz W, Rothmund M (2004) Hämorrhoidektomie: Konventionelle Exzision versus Resektion mit dem Klammernahtgerät. Dtsch Med Wochenschr 129:1611–1617PubMedCrossRef Hasse C, Sitter H, Brune M, Wollenteit I, Lorenz W, Rothmund M (2004) Hämorrhoidektomie: Konventionelle Exzision versus Resektion mit dem Klammernahtgerät. Dtsch Med Wochenschr 129:1611–1617PubMedCrossRef
48.
Zurück zum Zitat Ascanelli S, Gregorio C, Tonini G, Baccarini M, Azzena G (2005) Longo stapled haemorrhoidectomy versus Milligan–Morgan procedure: short- and long-term results of a randomised, controlled, prospective trial. Chirurgia Italiana 57:439–447PubMed Ascanelli S, Gregorio C, Tonini G, Baccarini M, Azzena G (2005) Longo stapled haemorrhoidectomy versus Milligan–Morgan procedure: short- and long-term results of a randomised, controlled, prospective trial. Chirurgia Italiana 57:439–447PubMed
49.
Zurück zum Zitat Nisar PJ, Acheson AG, Neal KR, Scholefield JH (2004) Stapled hemorrhoidopexy compared with conventional hemorrhoidectomy: systematic review of randomized controlled trials. Dis Colon Rectum 47:1837–1845PubMedCrossRef Nisar PJ, Acheson AG, Neal KR, Scholefield JH (2004) Stapled hemorrhoidopexy compared with conventional hemorrhoidectomy: systematic review of randomized controlled trials. Dis Colon Rectum 47:1837–1845PubMedCrossRef
50.
Zurück zum Zitat Lan P, Wu X, Zhou X, Wang J, Zhang L (2006) The safety and efficacy of stapled hemorrhoidectomy in the treatment of hemorrhoids: a systematic review and meta-analysis of ten randomized control trials. Int J Colorectal Disease 21:172–178CrossRef Lan P, Wu X, Zhou X, Wang J, Zhang L (2006) The safety and efficacy of stapled hemorrhoidectomy in the treatment of hemorrhoids: a systematic review and meta-analysis of ten randomized control trials. Int J Colorectal Disease 21:172–178CrossRef
Metadaten
Titel
Stapled haemorrhoidopexy compared to Milligan–Morgan and Ferguson haemorrhoidectomy: a systematic review
verfasst von
K. Laughlan
D. G. Jayne
D. Jackson
F. Rupprecht
G. Ribaric
Publikationsdatum
01.03.2009
Verlag
Springer-Verlag
Erschienen in
International Journal of Colorectal Disease / Ausgabe 3/2009
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-008-0611-0

Weitere Artikel der Ausgabe 3/2009

International Journal of Colorectal Disease 3/2009 Zur Ausgabe

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Was nützt die Kraniektomie bei schwerer tiefer Hirnblutung?

17.05.2024 Hirnblutung Nachrichten

Eine Studie zum Nutzen der druckentlastenden Kraniektomie nach schwerer tiefer supratentorieller Hirnblutung deutet einen Nutzen der Operation an. Für überlebende Patienten ist das dennoch nur eine bedingt gute Nachricht.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.