Systematic review of randomized trials comparing rubber band ligation with excisional haemorrhoidectomy
- 27 October 2005
- journal article
- research article
- Published by Oxford University Press (OUP) in British Journal of Surgery
- Vol. 92 (12), 1481-1487
- https://doi.org/10.1002/bjs.5185
Abstract
Background and method This review compares the two most popular treatments for haemorrhoids, namely rubber band ligation (RBL) and excisional haemorrhoidectomy. Randomized trials were identified from the major electronic databases. Symptom control, retreatment, postoperative pain, complications, time off work and patient satisfaction were assessed. Relative risk (RR) and weighted mean difference with 95 per cent confidence interval (c.i.) were estimated using a random-effects model for dichotomous and continuous outcomes respectively. Results Three trials met the inclusion criteria and all were of poor methodological quality. Complete remission of haemorrhoidal symptoms was better after haemorrhoidectomy (RR 1·68 (95 per cent c.i 1·00 to 2·83)). There was significant heterogeneity between the studies (I2 = 90·5 per cent; P < 0·001). Fewer patients required retreatment after haemorrhoidectomy (RR 0·20 (95 per cent c.i 0·09 to 0·40)), but anal stenosis, postoperative haemorrhage and incontinence to flatus were more common with this operation. Conclusions Haemorrhoidectomy produced better long-term symptom control in patients with grade III haemorrhoids, but was associated with more postoperative complications than RBL.This publication has 27 references indexed in Scilit:
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